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Tinner L, Palmer JC, Lloyd EC, Caldwell DM, MacArthur GJ, Dias K, Langford R, Redmore J, Wittkop L, Watkins SH, Hickman M, Campbell R. Individual-, family- and school-based interventions to prevent multiple risk behaviours relating to alcohol, tobacco and drug use in young people aged 8-25 years: a systematic review and meta-analysis. BMC Public Health 2022; 22:1111. [PMID: 35658920 PMCID: PMC9165543 DOI: 10.1186/s12889-022-13072-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 03/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Engagement in multiple substance use risk behaviours such as tobacco smoking, alcohol and drug use during adolescence can result in adverse health and social outcomes. The impact of interventions that address multiple substance use risk behaviours, and the differential impact of universal versus targeted approaches, is unclear given findings from systematic reviews have been mixed. Our objective was to assess effects of interventions targeting multiple substance use behaviours in adolescents. METHODS Eight databases were searched to October 2019. Individual and cluster randomised controlled trials were included if they addressed two or more substance use behaviours in individuals aged 8-25 years. Data were pooled in random-effects meta-analyses, reported by intervention and setting. Quality of evidence was assessed using GRADE. Heterogeneity was assessed using between-study variance, τ2 and Ι2, and the p-value of between-study heterogeneity statistic Q. Sensitivity analyses were undertaken using the highest and lowest intra-cluster correlation coefficient (ICC). RESULTS Of 66 included studies, most were universal (n=52) and school-based (n=41). We found moderate quality evidence that universal school-based interventions are likely to have little or no short-term benefit (up to 12 months) in relation to alcohol use (OR 0.94, 95% CI: 0.84, 1.04), tobacco use (OR 0.98, 95% CI: 0.83, 1.15), cannabis use (OR 1.06, 95% CI: 0.86, 1.31) and other illicit drug use (OR 1.09, 95% CI: 0.85, 1.39). For targeted school-level interventions, there was low quality evidence of no or a small short-term benefit: alcohol use (OR 0.90, 95% CI: 0.74-1.09), tobacco use (OR 0.86, 95% CI: 0.66, 1.11), cannabis use (OR 0.84, 95% CI: 0.66-1.07) and other illicit drug use (OR 0.79, 95% CI 0.62-1.02). There were too few family-level (n=4), individual-level (n=2) and combination level (n=5) studies to draw confident conclusions. Sensitivity analyses of ICC did not change results. CONCLUSIONS There is low to moderate quality evidence that universal and targeted school-level interventions have no or a small beneficial effect for preventing substance use multiple risk behaviours in adolescents. Higher quality trials and study reporting would allow better evidence syntheses, which is needed given small benefit of universal interventions can have high public health benefit. TRIAL REGISTRATION Cochrane Database of Systematic Reviews 2014, Issue 11. Art. No.: CD011374. DOI: 10.1002/14651858.CD011374.
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Affiliation(s)
- Laura Tinner
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK.
| | - Jennifer C Palmer
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - E Caitlin Lloyd
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
| | - Deborah M Caldwell
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Georgie J MacArthur
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Kaiseree Dias
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Rebecca Langford
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - James Redmore
- York Teaching Hospitals NHS Foundation Trust, Wiggington Road, York, UK
| | - Linda Wittkop
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
| | | | - Matthew Hickman
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Rona Campbell
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
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Peiris-John R, Dizon L, Sutcliffe K, Kang K, Fleming T. Co-creating a large-scale adolescent health survey integrated with access to digital health interventions. Digit Health 2020; 6:2055207620947962. [PMID: 32922828 PMCID: PMC7453446 DOI: 10.1177/2055207620947962] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 07/13/2020] [Indexed: 11/16/2022] Open
Abstract
Aim This paper describes how we engaged with adolescents and health providers to integrate access to digital health interventions as part of a large-scale secondary school health and wellbeing survey in New Zealand. Methods We conducted nine participatory, iterative co-design sessions involving 29 adolescents, and two workshops with young people (n = 11), digital and health service providers (n = 11) and researchers (n = 9) to gain insights into end-user perspectives on the concept and how best to integrate digital interventions in to the survey. Results Students’ perceived integrating access to digital health interventions into a large-scale youth health survey as acceptable and highly beneficial. They did not want personalized/normative feedback, but thought that every student should be offered all the help options. Participants identified key principles: assurance of confidentiality, usability, participant choice and control, and language. They highlighted wording as important for ease and comfort, and emphasised the importance of user control. Participants expressed that it would be useful and acceptable for survey respondents to receive information about digital help options addressing a range of health and wellbeing topics. Conclusion The methodology of adolescent-practitioner-researcher collaboration and partnership was central to this research and provided useful insights for the development and delivery of adolescent health surveys integrated with digital help options. The results from the ongoing study will provide useful data on the impact of digital health interventions integrated in large-scale surveys, as a novel methodology. Future research on engaging with adolescents once interventions are delivered will be useful to explore benefits over time.
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Affiliation(s)
- Roshini Peiris-John
- Section of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Lovely Dizon
- Section of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Kylie Sutcliffe
- Faculty of Health, Victoria University of Wellington, Wellington, New Zealand
| | - Kristy Kang
- Section of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Theresa Fleming
- Faculty of Health, Victoria University of Wellington, Wellington, New Zealand
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Junnual N, Sota C, Chaikoolvatana A. Effectiveness of a smoking cessation program on self-esteem, attitude, perception, and practice regarding control over smoking among male high school. JOURNAL OF HEALTH RESEARCH 2019. [DOI: 10.1108/jhr-05-2018-0016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose
The smoking rate of male high school students continues to increase. Therefore, the purpose of this paper is to examine the effectiveness of a smoking cessation program on self-esteem, attitude, perception and practice regarding smoking behavioral control among male high school students in Ubon Ratchathani Province, Thailand.
Design/methodology/approach
The effectiveness of the smoking cessation program was tested by a quasi-experimental pre-posttest and follow-up with a 24-week design. Multistage sampling was used to recruit 70 male high school students, including 35 male students in the intervention group and 35 male students in the control group. The intervention group received a 12-week smoking cessation program based on information-motivation-behavioral skills and stages of change models and follow-up at 12 weeks, whereas the control group did not. A self-administered questionnaire was used to assess the improvement of subjects’ self-esteem, attitude toward smoking, perceived control over smoking, number of cigarettes per day and urine cotinine test. The descriptive statistics, generalized estimating equation and proportion test were used for data analysis.
Findings
After the program, there were statistically significant differences in mean scores between the group and control groups; the difference of self-esteem was 4.15 (95% CI: 1.95, 6.36), attitude toward smoking was 3.30 (95% CI: 1.89, 5.52) and perceived control over smoking was 6.99 (95% CI: 4.04, 9.94). Thus, all differences in the intervention group were significantly higher than in the control group. The proportion of non-smokers, measured by the urine cotinine test at follow-up, was 25 percent (95% CI: 0.03, 0.48) significantly higher (p-value = 0.015), in the intervention group. Therefore, the smoking cessation program in this study was effective at changing the behavior of male high school student smokers.
Originality/value
This smoking cessation program increased self-esteem, attitude toward smoking, perceived control over smoking and decreased smoking per day among male high school students. Therefore, schools and parents should focus on developing these factors to encourage students to quit smoking.
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Khani Jeihooni A, Gholampour Y, Shokrpour N. Application of trans-theoretical model for smoking cessation in sample of Iranian men. JOURNAL OF SUBSTANCE USE 2019. [DOI: 10.1080/14659891.2019.1588402] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Ali Khani Jeihooni
- Department of Public Health, School of Health, Fasa University of Medical Sciences, Fasa, Iran
| | - Yousef Gholampour
- Department of Internal Medicine, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran
| | - Nasrin Shokrpour
- Department of English, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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Prevalences of Stages of Change for Smoking Cessation in Adolescents and Associated Factors: Systematic Review and Meta-Analysis. J Adolesc Health 2019; 64:149-157. [PMID: 30447952 DOI: 10.1016/j.jadohealth.2018.09.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 09/05/2018] [Accepted: 09/05/2018] [Indexed: 11/20/2022]
Abstract
PURPOSE To synthesize evidence on the prevalences of stages of change (Transtheoretical Model) for smoking cessation in adolescents and associated factors. METHODS A systematic search of Web of Science (Thomson Reuters), SCOPUS (Elsevier), MEDLINE/PubMed, CINAHL (EBSCO) and PsycINFO (APA) was conducted to identify eligible studies. Two calibrated reviewers selected studies independently, extracted data, and appraised studies. A qualitative synthesis of the findings and meta-analysis of the prevalences of the stages of change for smoking cessation were carried out. A quality effects model was used to estimate the pooled prevalences. RESULTS Eleven studies (N = 6469 adolescents) from five middle- to high-income countries were included in the review. Precontemplators accounted for 41% of smokers in earlier stages of change (95%CI: 34%-49%). In such a group, a lowered decisional balance, the lowest self-efficacy, and highest nicotine dependence were found (p < .05). CONCLUSIONS A higher overall prevalence of adolescents in precontemplation stage for smoking cessation was observed. Such group displayed more unfavorable smoking-related behaviors and characteristics than adolescents in other stages. The evidence is limited due to the lack of studies in adolescents living in low-income countries.
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Núñez O, Ramirez-Vélez R, Correa-Bautista JE. Etapas de cambio comportamental frente al consumo de sustancias psicoactivas en escolares de 9 a 17 años de Bogotá D.C., Colombia. REVISTA DE LA FACULTAD DE MEDICINA 2019. [DOI: 10.15446/revfacmed.v67n1.65501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Introducción. El consumo de sustancias psicoactivas (SPA) es una problemática que afecta a estudiantes desde edades tempranas.Objetivo. Describir las etapas de cambio de comportamiento frente al consumo de SPA en escolares de Bogotá D.C., Colombia.Materiales y métodos. Estudio transversal en 6 965 escolares de Bogotá D.C. El cambio de comportamiento se evaluó por autoreporte a través de un cuestionario estructurado a partir del Modelo Transteórico en las etapas de precontemplación, contemplación, preparación y acción/mantenimiento.Resultados. 58.4% fueron mujeres con edad promedio de 12.7±2.3 años. Frente al consumo de drogas alucinógenas, 6% de los escolares se ubicaron en la categoría de precontemplación, 44% en contemplación, 30% en preparación y 20% en acción/mantenimiento. Respecto al consumo de alcohol, 5% se encontraban en precontemplación, 36% en contemplación, 12% en preparación y 46% en acción/mantenimiento. El tabaquismo mostró prevalencias de 4% para precontemplación, 33% para contemplación, 12% para preparación y 51% para acción/mantenimiento.Conclusiones. El consumo de SPA es una problemática que se presenta cada vez con mayor frecuencia en población escolar. La mayoría de entrevistados se ubican en etapa de mantenimiento en el consumo de tabaco y alcohol y en la etapa de contemplación de consumo de drogas alucinógenas. Se requieren esfuerzos gubernamentales que fomenten programas preventivos de consumo de SPA en el ámbito escolar.
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Ramo DE, Kaur M, Corpuz ES, Satre DD, Delucchi K, Brown SA, Prochaska JJ. Using Facebook to address smoking and heavy drinking in young adults: Protocol for a randomized, controlled trial. Contemp Clin Trials 2018; 68:52-60. [PMID: 29510223 PMCID: PMC5937713 DOI: 10.1016/j.cct.2018.02.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 02/21/2018] [Accepted: 02/27/2018] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Tobacco and alcohol often are used simultaneously by young adults, and their co-use is associated with greater health consequences than from single use. Social media platforms offer low cost and highly accessible channels to reach and engage young people in substance use interventions. The current trial seeks to compare the Facebook Tobacco Status Project (TSP) smoking cessation intervention to an intervention targeting both tobacco use and heavy episodic drinking (TSP + ALC) among young adults who use both substances. METHODS This randomized clinical trial will evaluate the feasibility and initial efficacy of TSP + ALC compared to TSP with 225 US young adult smokers reporting heavy drinking. Participants will be recruited online and randomized to one of two conditions (TSP or TSP + ALC), both with assignment to a Facebook group tailored to readiness to quit smoking. Groups will receive a 90-day intervention including daily Facebook postings and weekly live counseling sessions. The TSP + ALC group will include content related to alcohol use. All participants will be offered a 2-week introductory supply of nicotine patch. Participants will complete baseline, 3-, 6-, and 12-month online assessments of substance use and other health risk behaviors. The primary efficacy outcome is biochemically-verified 7-day point prevalence abstinence. Secondary outcomes include alcohol and tobacco use, combined use, and thoughts about each substance. DISCUSSION This trial examines an innovative and scalable approach to engaging young adults online in tobacco and alcohol use treatment. Study findings will inform digital health interventions and best practices for treating multiple substance use in young adults.
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Affiliation(s)
- Danielle E Ramo
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States.
| | - Manpreet Kaur
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Ella S Corpuz
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Derek D Satre
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Kevin Delucchi
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Sandra A Brown
- Department of Psychology and Psychiatry, University of California, San Diego, La Jolla, CA, United States
| | - Judith J Prochaska
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, United States
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Kaner EFS, Beyer FR, Garnett C, Crane D, Brown J, Muirhead C, Redmore J, O'Donnell A, Newham JJ, de Vocht F, Hickman M, Brown H, Maniatopoulos G, Michie S. Personalised digital interventions for reducing hazardous and harmful alcohol consumption in community-dwelling populations. Cochrane Database Syst Rev 2017; 9:CD011479. [PMID: 28944453 PMCID: PMC6483779 DOI: 10.1002/14651858.cd011479.pub2] [Citation(s) in RCA: 149] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Excessive alcohol use contributes significantly to physical and psychological illness, injury and death, and a wide array of social harm in all age groups. A proven strategy for reducing excessive alcohol consumption levels is to offer a brief conversation-based intervention in primary care settings, but more recent technological innovations have enabled people to interact directly via computer, mobile device or smartphone with digital interventions designed to address problem alcohol consumption. OBJECTIVES To assess the effectiveness and cost-effectiveness of digital interventions for reducing hazardous and harmful alcohol consumption, alcohol-related problems, or both, in people living in the community, specifically: (i) Are digital interventions more effective and cost-effective than no intervention (or minimal input) controls? (ii) Are digital interventions at least equally effective as face-to-face brief alcohol interventions? (iii) What are the effective component behaviour change techniques (BCTs) of such interventions and their mechanisms of action? (iv) What theories or models have been used in the development and/or evaluation of the intervention? Secondary objectives were (i) to assess whether outcomes differ between trials where the digital intervention targets participants attending health, social care, education or other community-based settings and those where it is offered remotely via the internet or mobile phone platforms; (ii) to specify interventions according to their mode of delivery (e.g. functionality features) and assess the impact of mode of delivery on outcomes. SEARCH METHODS We searched CENTRAL, MEDLINE, PsycINFO, CINAHL, ERIC, HTA and Web of Knowledge databases; ClinicalTrials.com and WHO ICTRP trials registers and relevant websites to April 2017. We also checked the reference lists of included trials and relevant systematic reviews. SELECTION CRITERIA We included randomised controlled trials (RCTs) that evaluated the effectiveness of digital interventions compared with no intervention or with face-to-face interventions for reducing hazardous or harmful alcohol consumption in people living in the community and reported a measure of alcohol consumption. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by The Cochrane Collaboration. MAIN RESULTS We included 57 studies which randomised a total of 34,390 participants. The main sources of bias were from attrition and participant blinding (36% and 21% of studies respectively, high risk of bias). Forty one studies (42 comparisons, 19,241 participants) provided data for the primary meta-analysis, which demonstrated that participants using a digital intervention drank approximately 23 g alcohol weekly (95% CI 15 to 30) (about 3 UK units) less than participants who received no or minimal interventions at end of follow up (moderate-quality evidence).Fifteen studies (16 comparisons, 10,862 participants) demonstrated that participants who engaged with digital interventions had less than one drinking day per month fewer than no intervention controls (moderate-quality evidence), 15 studies (3587 participants) showed about one binge drinking session less per month in the intervention group compared to no intervention controls (moderate-quality evidence), and in 15 studies (9791 participants) intervention participants drank one unit per occasion less than no intervention control participants (moderate-quality evidence).Only five small studies (390 participants) compared digital and face-to-face interventions. There was no difference in alcohol consumption at end of follow up (MD 0.52 g/week, 95% CI -24.59 to 25.63; low-quality evidence). Thus, digital alcohol interventions produced broadly similar outcomes in these studies. No studies reported whether any adverse effects resulted from the interventions.A median of nine BCTs were used in experimental arms (range = 1 to 22). 'B' is an estimate of effect (MD in quantity of drinking, expressed in g/week) per unit increase in the BCT, and is a way to report whether individual BCTs are linked to the effect of the intervention. The BCTs of goal setting (B -43.94, 95% CI -78.59 to -9.30), problem solving (B -48.03, 95% CI -77.79 to -18.27), information about antecedents (B -74.20, 95% CI -117.72 to -30.68), behaviour substitution (B -123.71, 95% CI -184.63 to -62.80) and credible source (B -39.89, 95% CI -72.66 to -7.11) were significantly associated with reduced alcohol consumption in unadjusted models. In a multivariable model that included BCTs with B > 23 in the unadjusted model, the BCTs of behaviour substitution (B -95.12, 95% CI -162.90 to -27.34), problem solving (B -45.92, 95% CI -90.97 to -0.87), and credible source (B -32.09, 95% CI -60.64 to -3.55) were associated with reduced alcohol consumption.The most frequently mentioned theories or models in the included studies were Motivational Interviewing Theory (7/20), Transtheoretical Model (6/20) and Social Norms Theory (6/20). Over half of the interventions (n = 21, 51%) made no mention of theory. Only two studies used theory to select participants or tailor the intervention. There was no evidence of an association between reporting theory use and intervention effectiveness. AUTHORS' CONCLUSIONS There is moderate-quality evidence that digital interventions may lower alcohol consumption, with an average reduction of up to three (UK) standard drinks per week compared to control participants. Substantial heterogeneity and risk of performance and publication bias may mean the reduction was lower. Low-quality evidence from fewer studies suggested there may be little or no difference in impact on alcohol consumption between digital and face-to-face interventions.The BCTs of behaviour substitution, problem solving and credible source were associated with the effectiveness of digital interventions to reduce alcohol consumption and warrant further investigation in an experimental context.Reporting of theory use was very limited and often unclear when present. Over half of the interventions made no reference to any theories. Limited reporting of theory use was unrelated to heterogeneity in intervention effectiveness.
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Affiliation(s)
- Eileen FS Kaner
- Newcastle UniversityInstitute of Health and SocietyRichardson RoadNewcastle upon TyneUKNE2 4AX
| | - Fiona R Beyer
- Newcastle UniversityInstitute of Health and SocietyRichardson RoadNewcastle upon TyneUKNE2 4AX
| | - Claire Garnett
- University College LondonResearch Department of Clinical, Educational and Health Psychology1‐19 Torrington PlaceLondonUKWC1E 7HB
| | - David Crane
- University College LondonResearch Department of Clinical, Educational and Health Psychology1‐19 Torrington PlaceLondonUKWC1E 7HB
| | - Jamie Brown
- University College LondonResearch Department of Clinical, Educational and Health Psychology1‐19 Torrington PlaceLondonUKWC1E 7HB
| | - Colin Muirhead
- Newcastle UniversityInstitute of Health and SocietyRichardson RoadNewcastle upon TyneUKNE2 4AX
| | - James Redmore
- University of BristolPopulation Health Sciences, Bristol Medical School39 Whatley RoadBristolUKBS8 2PS
| | - Amy O'Donnell
- Newcastle UniversityInstitute of Health and SocietyRichardson RoadNewcastle upon TyneUKNE2 4AX
| | - James J Newham
- King's College LondonPrimary Care & Public Health SciencesAddison House, Guy's campusLondonUKSE1 1UL
| | - Frank de Vocht
- University of BristolSchool of Social and Community Medicine39 Whatley RoadBristolUKBS8 2PS
| | - Matthew Hickman
- University of BristolSchool of Social and Community Medicine39 Whatley RoadBristolUKBS8 2PS
| | - Heather Brown
- Newcastle UniversityInstitute of Health and SocietyRichardson RoadNewcastle upon TyneUKNE2 4AX
| | - Gregory Maniatopoulos
- Newcastle UniversityInstitute of Health and SocietyRichardson RoadNewcastle upon TyneUKNE2 4AX
| | - Susan Michie
- University College LondonResearch Department of Clinical, Educational and Health Psychology1‐19 Torrington PlaceLondonUKWC1E 7HB
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Dupont HB, Candel MJJM, Lemmens P, Kaplan CD, van de Mheen D, De Vries NK. Stages of Change Model has Limited Value in Explaining the Change in Use of Cannabis among Adolescent Participants in an Efficacious Motivational Interviewing Intervention. J Psychoactive Drugs 2017; 49:363-372. [PMID: 28548619 DOI: 10.1080/02791072.2017.1325030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Previously, a Dutch randomized controlled trial evaluating an intervention aimed at changing adolescents' cannabis use, called Moti-4, has shown its efficacy. A secondary analysis of the Moti-4 data investigated the process of change specified by the Stage of Change (SOC) model in cannabis use during the trial. Seventy-one Moti-4 participants and 60 controls were recruited for the study with a pre-test, post-test (T1), and six-month follow-up (T2). All participants showed signs of problematic cannabis use. No contribution of the Moti-4 intervention to a change in SOC between T1 and T2 was found. Although motivation for treatment and motivation for change can be conceived as independent predictors of treatment outcome, the SOC a person is in does not mediate the effect of the intervention on change in cannabis use. However, a reduction in cannabis use was associated with a positive change in "action willingness," in line with the SOC model. In contrast to model expectations, a higher score on "contemplation" is associated with a higher cannabis consumption. Results highlight both the limitations and usefulness of the SOC model. Future interventions may focus more on the stage of "action willingness," as well as on perceived social norms.
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Affiliation(s)
- Hans B Dupont
- a Moti-4 Research Project Coordinator, CAPHRI, School for Public Health and Primary Care , Maastricht University , Maastricht , the Netherlands.,b Manager, Addiction Prevention Department , Mondriaan , Heerlen , the Netherlands
| | - Math J J M Candel
- b Manager, Addiction Prevention Department , Mondriaan , Heerlen , the Netherlands
| | - Paul Lemmens
- c Professor, Statistical Department, CAPHRI, School for Public Health and Primary Care , Maastricht University , Maastricht , the Netherlands
| | - Charles D Kaplan
- d Assistant Professor, CAPHRI, School for Public Health and Primary Care , Maastricht University , Maastricht , the Netherlands
| | - Dike van de Mheen
- e Research Professor and Associate Dean of Research, Hamovitch Center for Science in the Human Services, School of Social Work , University of Southern California , Los Angeles , CA , USA.,f Professor, Tranzo, School of Social and Behavioral Sciences, Tilburg University , Tilburg , the Netherlands.,g Manager, Addiction Research Institute , Rotterdam , the Netherlands
| | - Nanne K De Vries
- h Dean, CAPHRI, School for Public Health and Primary Care , Maastricht University , Maastricht , the Netherlands
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Abstract
Adolescent girls are an important target group for breast cancer education and promoting breast awareness. However, research has not established schoolgirls' perceived importance of breast cancer education or explored factors that may impact engagement. This study aimed to identify schoolgirls' concerns about breast cancer, desire to know more and perceived importance of breast cancer education, and explored associations with demographic factors. Of 2089 schoolgirls (11-18 years) surveyed, 1958 completed all relevant breast cancer questions and demographic factors (ethnicity, school type, breast size, physical activity level and age). χ-Tests assessed associations between demographics, desire to know more and perceived importance of breast cancer. Overall, 44% of schoolgirls reported concerns about breast cancer, 72% wanted to know more and 77% rated the topic as extremely important. Breast size was not associated with wanting to know more about breast cancer. Schoolgirls who wanted to know more about breast cancer were White, from single-sex schools with boys at sixth form, more physically active and older. However, among other ethnic groups, school types and physical activity levels, the proportion of girls who wanted to know more about breast cancer was still high (≥61%). This study provides evidence of the need for breast cancer education for schoolgirls across all school types, irrespective of breast size or physical activity levels. The results highlight the need to be inclusive and engage schoolgirls from all ethnic groups and to promote breast awareness at a young age to ensure effective breast cancer education.
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Ghahremani L, mousavi Z, Kaveh MH, Ghaem H. Self-Care Education Programs Based on a Trans-Theoretical Model in Women Referring to Health Centers: Breast Self-Examination Behavior in Iran. Asian Pac J Cancer Prev 2016; 17:5133-5138. [PMID: 28122446 PMCID: PMC5454648 DOI: 10.22034/apjcp.2016.17.12.5133] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background: Breast cancer is one of the most common cancers and a major public health problem in developing countries. However, early detection and treatment may be achieved by breast self-examination (BSE). Despite the importance of BSE in reducing the incidence of breast cancer and esultant deaths, the disease continues to be the most common cause of cancer death among women in Iran. This study aimed to determine the effects of self-care education on performance of BSE among women referring to health centers in our country. Materials and Methods: This quasi-experimental interventional study with pretest/posttest control group design was conducted on 168 women referred to health centers. The data were collected using a validated researcher-made questionnaire including demographic variables and trans-theoretical model constructs as well as a checklist assessing BSE behavior. The instruments were administered to groups with and without self-care education before, a week after, and 10 weeks after the intervention. Then, the data were entered into the SPSS statistical software (version 19) and analyzed using independent sample t-tests, paired sample t-test, repeated measures ANOVA, Chi-square, and Friedman tests (p<0.05). Results: The results showed an increase in the intervention group’s mean scores of trans-theoretical model constructs (stages of change, self-efficacy, decisional balance, and processes of change) and BSE behavior compared to the control group (p<0.001). Conclusion: The study confirmed the effectiveness of aneducational intervention based ona trans-theoretical model in performing BSE. Therefore, designing educational interventions based on this model is recommended to improve women’s health and reduce deaths due to breast cancer.
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Affiliation(s)
- Leila Ghahremani
- Department of health education and promotion, School of Health, Shiraz University of Medical Sciences ,Shiraz, Iran.
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StopApp: Using the Behaviour Change Wheel to Develop an App to Increase Uptake and Attendance at NHS Stop Smoking Services. Healthcare (Basel) 2016; 4:healthcare4020031. [PMID: 27417619 PMCID: PMC4934584 DOI: 10.3390/healthcare4020031] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 05/26/2016] [Accepted: 05/31/2016] [Indexed: 11/17/2022] Open
Abstract
Smokers who attend NHS Stop Smoking Services (SSS) are four times more likely to stop smoking; however, uptake has been in decline. We report the development of an intervention designed to increase uptake of SSS, from a more motivated self-selected sample of smokers. In Phase 1 we collected data to explore the barriers and facilitators to people using SSS. In Phase 2, data from extant literature and Phase 1 were subject to behavioural analysis, as outlined by the Behaviour Change Wheel (BCW) framework. Relevant Behaviour Change Techniques (BCTs) were identified in order to address these, informing the content of the StopApp intervention. In Phase 3 we assessed the acceptability of the StopApp. Smokers and ex-smokers identified a number of barriers to attending SSS, including a lack of knowledge about what happens at SSS (Capability); the belief that SSS is not easy to access (Opportunity); that there would be ’scare tactics’ or ‘nagging’; and not knowing anyone who had been and successfully quit (Motivation). The ‘StopApp’ is in development and will link in with the commissioned SSS booking system. Examples of the content and functionality of the app are outlined. The next phase will involve a full trial to test effectiveness.
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Segrott J, Rothwell H, Hewitt G, Playle R, Huang C, Murphy S, Moore L, Hickman M, Reed H. Preventing alcohol misuse in young people: an exploratory cluster randomised controlled trial of the Kids, Adults Together (KAT) programme. PUBLIC HEALTH RESEARCH 2015. [DOI: 10.3310/phr03150] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundInvolvement of parents/carers may increase the effectiveness of primary school-based alcohol-misuse prevention projects. However, few interventions have been designed for pre-adolescent children, or specifically involve parents/carers. The Kids, Adults Together (KAT) programme in primary schools aimed to reduce alcohol misuse through such an approach.ObjectiveTo determine the value and feasibility of conducting an effectiveness trial of KAT.DesignParallel-group cluster randomised exploratory trial with an embedded process evaluation. Schools were the unit of randomisation.SettingPrimary schools (n = 9) in south Wales, UK.ParticipantsPupils in Year 5/6 (aged 9–11 years) and their parents/carers; school staff.InterventionThe Kids, Adults Together programme consisted of (1) classwork addressing the effects of alcohol; (2) a family event for children and parents/carers; and (3) a ‘goody bag’ containing fun items, including a digital versatile disc (DVD) for families to watch together. The intervention comprised KAT plus existing alcohol-related activities and lessons. Control-group schools continued with existing alcohol-related lessons and activities.Main outcome measuresKey outcomes related to the progression criteria for a potential future effectiveness trial. These included the acceptability, participation equity, feasibility and implementation of KAT; the recruitment and retention of research participants; and the acceptability and feasibility of research processes, including data collection methods and outcome measures.ResultsNine schools (free school meal entitlement ranging from 1% to 37.2%) participated. Two of five intervention schools withdrew but all four control schools were retained, and these seven schools facilitated all research data collections. Programme acceptability and participation rates were high in all three intervention schools (parent/carer participation rates ranged from 45.1% to 65.7%), although implementation quality varied. At baseline, approximately 75% of eligible children (n = 418) provided data, of whom 257 also provided data at follow-up. Only 27 parents/carers (estimated response rate 6.5%) completed interviews. Most children were willing to complete questionnaires but measures were not appropriate for this age group. Measures of alcohol consumption produced inconsistent responses. Intermediate outcomes on family communication showed no evidence of intervention effectiveness.ConclusionsIn the three schools that received the KAT intervention, it was found to be acceptable to schools and pupils and there were good levels of participation from parents/carers from across a range of socioeconomic groups. However, two intervention schools withdrew from the trial. Findings from intermediate outcomes on family communication did not support programme theory. In addition, the study highlighted challenges in identifying suitable outcome measures for children aged 9–11 years and the feasibility of long-term follow-up via secondary schools.Future workIt would not be appropriate to proceed to an effectiveness trial of KAT. There are doubts/uncertainties about the potential effects of KAT; suitability of measures; the large number of schools which would be required for an effectiveness trial of KAT, and the cost of this; feasibility of follow-up in secondary schools; and programme implementation and theory. There is a need to develop and validate measures for children aged 9–11 years; to test the feasibility of follow-up data collection methods in secondary schools; and to further consider sample size requirements and feasibility.Trial registrationCurrent Controlled Trials ISRCTN80672127.FundingThe exploratory trial of this project was funded by the National Institute for Health Research Public Health Research programme and the process evaluation was funded by the Economic and Social Research Council. The work was undertaken with the support of The Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), a UK Clinical Research Collaboration Public Health Research Centre of Excellence. Joint funding (MR/KO232331/1) from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, the Welsh Government and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged. This project will be published in full inPublic Health Research; Vol. 3, No. 15. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Jeremy Segrott
- Cardiff School of Social Sciences, Cardiff University, Cardiff, UK
- UKCRC Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), Cardiff University, Cardiff, UK
| | - Heather Rothwell
- Cardiff School of Social Sciences, Cardiff University, Cardiff, UK
- UKCRC Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), Cardiff University, Cardiff, UK
| | - Gillian Hewitt
- Cardiff School of Social Sciences, Cardiff University, Cardiff, UK
- UKCRC Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), Cardiff University, Cardiff, UK
| | - Rebecca Playle
- South East Wales Trials Unit (SEWTU), Cardiff University, Cardiff, UK
| | - Chao Huang
- South East Wales Trials Unit (SEWTU), Cardiff University, Cardiff, UK
| | - Simon Murphy
- Cardiff School of Social Sciences, Cardiff University, Cardiff, UK
- UKCRC Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), Cardiff University, Cardiff, UK
| | - Laurence Moore
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Matthew Hickman
- School of Social and Community Medicine, University of Bristol, Bristol, UK
- UKCRC Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), University of Bristol, Bristol, UK
| | - Hayley Reed
- Cardiff School of Social Sciences, Cardiff University, Cardiff, UK
- UKCRC Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), Cardiff University, Cardiff, UK
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Athamneh L, Sansgiry SS, Essien EJ, Abughosh S. Predictors of intention to quit waterpipe smoking: a survey of arab americans in houston, Texas. JOURNAL OF ADDICTION 2015; 2015:575479. [PMID: 25821629 PMCID: PMC4364118 DOI: 10.1155/2015/575479] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Revised: 01/24/2015] [Accepted: 02/19/2015] [Indexed: 11/18/2022]
Abstract
Waterpipe smoking has been described as "the second global tobacco epidemic since the cigarette." Both Middle Eastern ethnicity and having a friend of Middle Eastern ethnicity have been reported as significant predictors of waterpipe smoking. Addressing waterpipe smoking in this ethnic minority is essential to controlling this growing epidemic in the US. We investigated the predictors of an intention to quit waterpipe smoking by surveying 340 Arab American adults in the Houston area. Primary analyses were conducted using stepwise logistic regression. Only 27% of participants reported having an intention to quit waterpipe smoking. Intention to quit waterpipe smoking was significantly higher with history of cigar use, a prior attempt to quit, and not smoking when seriously ill and significantly lower with increasing age, medium cultural acceptability of using waterpipe among family, high cultural acceptability of using waterpipe among friends, longer duration of smoking sessions, and perceiving waterpipe smoking as less harmful than cigarettes. Educational programs that target Arab Americans in general, and specifically older adults, those who smoke waterpipe for more than 60 minutes, those whose family and friends approve waterpipe smoking, and those with no former attempts to quit, may be necessary to increase the intention to quit waterpipe smoking.
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Affiliation(s)
- Liqa Athamneh
- Department of Pharmaceutical Health Outcomes and Policy, Texas Medical Center, University of Houston, 1441 Moursund Street, Houston, TX 77030, USA
| | - Sujit S. Sansgiry
- Department of Pharmaceutical Health Outcomes and Policy, Texas Medical Center, University of Houston, 1441 Moursund Street, Houston, TX 77030, USA
| | - E. James Essien
- Department of Pharmaceutical Health Outcomes and Policy, Texas Medical Center, University of Houston, 1441 Moursund Street, Houston, TX 77030, USA
- The University of Texas School of Public Health, 7000 Fannin Street, Houston, TX 77030, USA
| | - Susan Abughosh
- Department of Pharmaceutical Health Outcomes and Policy, Texas Medical Center, University of Houston, 1441 Moursund Street, Houston, TX 77030, USA
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Agabio R, Trincas G, Floris F, Mura G, Sancassiani F, Angermeyer MC. A Systematic Review of School-Based Alcohol and other Drug Prevention Programs. Clin Pract Epidemiol Ment Health 2015; 11:102-12. [PMID: 25834630 PMCID: PMC4378029 DOI: 10.2174/1745017901511010102] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2014] [Revised: 10/20/2014] [Accepted: 10/20/2014] [Indexed: 12/27/2022]
Abstract
BACKGROUND Alcohol use in adolescents constitutes a major public health concern. Europe is the heaviest drinking region of the world. Several school-based alcohol prevention programs have been developed but it is not clear whether they are really effective. The present study was aimed at identifying the typology with the best evidence of effectiveness in European studies. METHODS A systematic search of meta-analyses and/or randomized controlled trials (RCTs) on interventions school-based prevention programs aimed at preventing alcohol consumption or changing the attitudes to consume alcohol. RESULTS A meta-analysis published in 2011 and 12 RCTs more recently published were identified. The meta-analysis evaluated 53 RCTs but only 11.3% of them were conducted in Europe. Globally, 23 RCTs (43.4%) showed some evidence of effectiveness, and 30 RCTs (56.6%) did not find significant difference between the groups. According to the conclusions of the meta-analysis, the Unplugged program should be considered as a practice option in Europe. Among the other 12 RCTs, 42% were conducted in Europe. Globally, 7 studies (58.3%) achieved positive results, and 5 studies (41.7%) did not find significant differences or produced a mixed pattern of results. Three of the 5 European trials (60%) used the Unplugged program with positive results. CONCLUSION Even if further studies should be conducted to confirm these results, Unplugged appears to be the prevention project with the best evidence of effectiveness in European studies.
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Affiliation(s)
- Roberta Agabio
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, Italy
| | - Giuseppina Trincas
- Department of Public Health and Clinical and Molecular Medicine and Unit of Psychosomatics and Clinical Psychiatry, University Hospital, University of Cagliari, Cagliari, Italy
| | - Francesca Floris
- Department of Public Health and Clinical and Molecular Medicine and Unit of Psychosomatics and Clinical Psychiatry, University Hospital, University of Cagliari, Cagliari, Italy
| | - Gioia Mura
- Department of Public Health and Clinical and Molecular Medicine and Unit of Psychosomatics and Clinical Psychiatry, University Hospital, University of Cagliari, Cagliari, Italy
| | - Federica Sancassiani
- Department of Public Health and Clinical and Molecular Medicine and Unit of Psychosomatics and Clinical Psychiatry, University Hospital, University of Cagliari, Cagliari, Italy
| | - Matthias C Angermeyer
- Department of Public Health and Clinical and Molecular Medicine and Unit of Psychosomatics and Clinical Psychiatry, University Hospital, University of Cagliari, Cagliari, Italy ; Center for Public Mental Health, Gosim, Austria
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16
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Velloza J, L'Engle K, Mwarogo P, Chokwe J, Magaria L, Sinkele W, Kingola N. Stages and Processes of Change Utilized by Female Sex Workers Participating in an Alcohol-Reduction Intervention in Mombasa, Kenya. Subst Use Misuse 2015; 50:1728-37. [PMID: 26595484 DOI: 10.3109/10826084.2015.1037397] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND According to the transtheoretical model (TTM) behavior change occurs through a series of steps when an individual becomes aware of a behavior, prepares to change, and executes those changes using certain processes. This model has not yet been used to describe alcohol-reduction behavior change processes in resource-limited settings. OBJECTIVE This qualitative analysis aimed to describe and characterize the stages and processes of change employed by female sex workers in Mombasa, Kenya during the course of their participation in a 6-month alcohol reduction intervention. METHODS In 2011-2012, clinical interviews were conducted with 45 female sex workers. One interview was conducted each month during the intervention period, resulting in a total of six transcripts per participant. During each interview, the counselor noted the participant's stage of change and recent alcohol use. The clinical notes were analyzed via qualitative coding techniques and organized into matrices to classify alcohol reduction strategies discussed by participants. RESULTS Participants discussed using the stage-specific processes of change described by the TTM to reduce their alcohol use and maintain the behavior change. Participants who were HIV-positive at the start of the intervention seemed to progress to the action/maintenance stage more quickly than HIV-negative participants. CONCLUSIONS/IMPORTANCE Results suggest that the TTM constructs may be relevant in understanding the alcohol reduction behavior change process of an at-risk population in a resource-limited setting. Future quantitative research should seek to validate the TTM's application internationally. Alcohol interventions should consider tailoring content to participants' stages of change and HIV-status for increased effectiveness.
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Affiliation(s)
| | | | | | - Jackie Chokwe
- c International Center for Reproductive Health (ICRH) , Mombasa , Kenya
| | | | - William Sinkele
- d Support for Addictions Prevention and Treatment in Africa (SAPTA) , Nairobi , Kenya
| | - Nzioki Kingola
- c International Center for Reproductive Health (ICRH) , Mombasa , Kenya
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Affiliation(s)
- Daniel Selling
- NYC Department of Health and Mental Hygiene, Correctional Health Services, New York City, NY, USA
| | - David Lee
- NYC Department of Health and Mental Hygiene, Correctional Health Services, New York City, NY, USA
| | - Angela Solimo
- NYC Department of Health and Mental Hygiene, Correctional Health Services, New York City, NY, USA
| | - Homer Venters
- NYC Department of Health and Mental Hygiene, Correctional Health Services, New York City, NY, USA
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Abstract
Alcohol continues to be a major contributor to morbidity and mortality globally. Despite the scientific advances, alcohol use related problems continue to pose a major challenge to medicine and public health. Internet offers a new mode to provide health care interventions. Web based interventions (WBIs) provide the health care services at the door steps of the end users. WBIs have been developed for alcohol use related problems over the past few years. WBIs offer a potentially relevant and viable mode of service delivery to problem alcohol users. Hence, it is important to assess these interventions for their effectiveness. Some of the existing WBIs for alcohol use assessed systematically in controlled trials. The current review evaluates the available evidence for the effectiveness of WBIs for reducing alcohol use. The literature search was performed using MedLine, PubMed, PsycINFO and EMBASE for relevant English language articles published up to and including April 2013. Only publications focused on reducing alcohol use through WBIs were included.
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Affiliation(s)
- Yps Balhara
- Department of Psychiatry, National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
| | - R Verma
- Department of Psychiatry, Lady Hardinge Medical College and SSK Hospital, New Delhi, India
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Park E, Drake E. Systematic review: internet-based program for youth smoking prevention and cessation. J Nurs Scholarsh 2014; 47:43-50. [PMID: 25130325 DOI: 10.1111/jnu.12104] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2014] [Indexed: 11/26/2022]
Abstract
PURPOSE To review the characteristics and effects Internet-based youth smoking prevention and cessation programs. DESIGN Systematic review of published articles in peer-reviewed journals in the past 10 years, focused on Internet-based youth smoking prevention and cessation programs. METHODS Twelve articles were selected based on the following criteria: studies reporting the outcomes of Internet-based smoking cessation or prevention intervention programs for adolescents who are younger than 24 years. FINDINGS The components of youth Internet-based smoking intervention programs are analyzed based on study features (i.e., sample, design, theoretical basis, analysis, outcome measures) and program characteristics (i.e., focus, setting, frequency, duration, intensity, and different components) that make the programs effective. The most common components of effective Internet-based programs are identified as the following: the use of multimedia, tailored approaches, personalized feedback, and interactive features. CONCLUSIONS The characteristics and effects of the programs vary, but most programs show positive results in youth smoking prevention and cessation in spite of the studies' limitations. CLINICAL RELEVANCE The evidence from this review provides useful information of recent efforts related to Internet-based youth smoking prevention and cessation programs, which can have significant clinical implications in developing future innovative youth smoking prevention and intervention programs.
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Affiliation(s)
- Eunhee Park
- Beta Kappa, Doctoral Student, University of Virginia, Charlottesville, VA, USA
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20
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Kim HH, Seo HJ. HealthTWITTER Initiative: Design of a Social Networking Service Based Tailored Application for Diabetes Self-Management. Healthc Inform Res 2014; 20:226-30. [PMID: 25152836 PMCID: PMC4141137 DOI: 10.4258/hir.2014.20.3.226] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 07/28/2014] [Accepted: 07/29/2014] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES Diabetes is a chronic disease of continuously increasing prevalence. It is a disease with risks of serious complications, thus warranting its long-term management. However, current health management and education programs for diabetes mainly consist of one-way communication, and systematic social support backup to solve diabetics' emotional problems is insufficient. METHODS According to individual behavioral changes based on the Transtheoretical Model, we designed a non-drug intervention, including exercise, and applied it to a mobile based application. For effective data sharing between patients and physicians, we adopted an SNS function for our application in order to offer a social support environment. RESULTS To induce continual and comprehensive care for diabetes, rigorous self-management is essential during the diabetic's life; this is possible through a collaborative patient-physician healthcare model. We designed and developed an SNS-based diabetes self-management mobile application that supports the use of social groups, which are present in three social GYM types. With simple testing of patients in their 20s and 30s, we were able to validate the usefulness of our application. CONCLUSIONS Mobile gadget-based chronic disease symptom management and intervention has the merit that health management can be conducted anywhere and anytime in order to cope with increases in the demand for health and medical services that are occurring due to the aging of the population and to cope with the surge of national medical service costs. This patient-driven and SNS-based intervention program is expected to contribute to promoting the health management habits of diabetics, who need to constantly receive health guidance.
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Affiliation(s)
- Hye Hyeon Kim
- Seoul National University Biomedical Informatics (SNUBI), Seoul National University College of Medicine, Seoul, Korea
| | - Hwa Jeong Seo
- Medical Informatics and Health Technology (MIT), Department of Health Care Management, College of Social Science, Gachon University, Seongnam, Korea
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21
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Thomas RE, McLellan J, Perera R. School-based programmes for preventing smoking. ACTA ACUST UNITED AC 2013. [DOI: 10.1002/ebch.1937] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Linke SE, Robinson CJ, Pekmezi D. Applying Psychological Theories to Promote Healthy Lifestyles. Am J Lifestyle Med 2013. [DOI: 10.1177/1559827613487496] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Over the past few decades, researchers have been developing and refining psychological theories and models to provide solid behavioral frameworks for evidence-based research. Each year new theories and models are created; however, a select few appear to have withstood the test of time and continue to be frequently utilized in present-day research. The objectives of this review are to highlight these psychological theories and models and describe their application to various public health issues and behaviors. Descriptions and example applications of the following theories and models are described in this review: health belief model, theory of reasoned action/planned behavior, social cognitive theory, transtheoretical model, and socioecological model.
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Affiliation(s)
- Sarah E. Linke
- Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, California (SEL)
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, Alabama (CJR, DP)
| | - Cody J. Robinson
- Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, California (SEL)
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, Alabama (CJR, DP)
| | - Dorothy Pekmezi
- Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, California (SEL)
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, Alabama (CJR, DP)
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Abstract
BACKGROUND Helping young people to avoid starting smoking is a widely endorsed public health goal, and schools provide a route to communicate with nearly all young people. School-based interventions have been delivered for close to 40 years. OBJECTIVES The primary aim of this review was to determine whether school smoking interventions prevent youth from starting smoking. Our secondary objective was to determine which interventions were most effective. This included evaluating the effects of theoretical approaches; additional booster sessions; programme deliverers; gender effects; and multifocal interventions versus those focused solely on smoking. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane Tobacco Addiction Group's Specialised Register, MEDLINE, EMBASE, PsycINFO, ERIC, CINAHL, Health Star, and Dissertation Abstracts for terms relating to school-based smoking cessation programmes. In addition, we screened the bibliographies of articles and ran individual MEDLINE searches for 133 authors who had undertaken randomised controlled trials in this area. The most recent searches were conducted in October 2012. SELECTION CRITERIA We selected randomised controlled trials (RCTs) where students, classes, schools, or school districts were randomised to intervention arm(s) versus a control group, and followed for at least six months. Participants had to be youth (aged 5 to 18). Interventions could be any curricula used in a school setting to deter tobacco use, and outcome measures could be never smoking, frequency of smoking, number of cigarettes smoked, or smoking indices. DATA COLLECTION AND ANALYSIS Two reviewers independently assessed studies for inclusion, extracted data and assessed risk of bias. Based on the type of outcome, we placed studies into three groups for analysis: Pure Prevention cohorts (Group 1), Change in Smoking Behaviour over time (Group 2) and Point Prevalence of Smoking (Group 3). MAIN RESULTS One hundred and thirty-four studies involving 428,293 participants met the inclusion criteria. Some studies provided data for more than one group.Pure Prevention cohorts (Group 1) included 49 studies (N = 142,447). Pooled results at follow-up at one year or less found no overall effect of intervention curricula versus control (odds ratio (OR) 0.94, 95% confidence interval (CI) 0.85 to 1.05). In a subgroup analysis, the combined social competence and social influences curricula (six RCTs) showed a statistically significant effect in preventing the onset of smoking (OR 0.49, 95% CI 0.28 to 0.87; seven arms); whereas significant effects were not detected in programmes involving information only (OR 0.12, 95% CI 0.00 to 14.87; one study), social influences only (OR 1.00, 95% CI 0.88 to 1.13; 25 studies), or multimodal interventions (OR 0.89, 95% CI 0.73 to 1.08; five studies). In contrast, pooled results at longest follow-up showed an overall significant effect favouring the intervention (OR 0.88, 95% CI 0.82 to 0.96). Subgroup analyses detected significant effects in programmes with social competence curricula (OR 0.52, 95% CI 0.30 to 0.88), and the combined social competence and social influences curricula (OR 0.50, 95% CI 0.28 to 0.87), but not in those programmes with information only, social influence only, and multimodal programmes.Change in Smoking Behaviour over time (Group 2) included 15 studies (N = 45,555). At one year or less there was a small but statistically significant effect favouring controls (standardised mean difference (SMD) 0.04, 95% CI 0.02 to 0.06). For follow-up longer than one year there was a statistically nonsignificant effect (SMD 0.02, 95% CI -0.00 to 0.02).Twenty-five studies reported data on the Point Prevalence of Smoking (Group 3), though heterogeneity in this group was too high for data to be pooled.We were unable to analyse data for 49 studies (N = 152,544).Subgroup analyses (Pure Prevention cohorts only) demonstrated that at longest follow-up for all curricula combined, there was a significant effect favouring adult presenters (OR 0.88, 95% CI 0.81 to 0.96). There were no differences between tobacco-only and multifocal interventions. For curricula with booster sessions there was a significant effect only for combined social competence and social influences interventions with follow-up of one year or less (OR 0.50, 95% CI 0.26 to 0.96) and at longest follow-up (OR 0.51, 95% CI 0.27 to 0.96). Limited data on gender differences suggested no overall effect, although one study found an effect of multimodal intervention at one year for male students. Sensitivity analyses for Pure Prevention cohorts and Change in Smoking Behaviour over time outcomes suggested that neither selection nor attrition bias affected the results. AUTHORS' CONCLUSIONS Pure Prevention cohorts showed a significant effect at longest follow-up, with an average 12% reduction in starting smoking compared to the control groups. However, no overall effect was detected at one year or less. The combined social competence and social influences interventions showed a significant effect at one year and at longest follow-up. Studies that deployed a social influences programme showed no overall effect at any time point; multimodal interventions and those with an information-only approach were similarly ineffective.Studies reporting Change in Smoking Behaviour over time did not show an overall effect, but at an intervention level there were positive findings for social competence and combined social competence and social influences interventions.
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Affiliation(s)
- Roger E Thomas
- Department of Family Medicine, Faculty of Medicine, University of Calgary, Calgary, Canada.
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Benzo R. Collaborative self-management in chronic obstructive pulmonary disease: learning ways to promote patient motivation and behavioral change. Chron Respir Dis 2013; 9:257-8. [PMID: 23129803 DOI: 10.1177/1479972312458683] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Roberto Benzo
- Mindful Breathing Laboratory, Division of Pulmonary & Critical Care, Mayo Clinic, Rochester, MN, USA.
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