Assessing demographic differences in decisional balance for smoking prevention and temptations to try smoking among adolescent subgroups

The reliability and validity of the Temptations to Try Smoking Scale in a group of Chinese adolescents

OBJECTIVE

To provide a scientifc tool, the Temptations to Try Smoking Scale (TTSS) is introduced to evaluate its reliability and validity in preventing and intervening Chinese adolescents from smoking temptations.

METHODS

A questionnaire, including the TTSS, the Chinese version of the Decisional Balance Scale (CDBS), the Adolescent Smoking Curiosity Scale (ASCOS), and the Sensation-Seeking Scale (SSS), is used to test 1195 Chinese adolescent volunteers (214 of them are retested after 1 month). If all six items in the TTSS are retained, the exploratory factor analysis (EFA) reveals that the TTSS exhibits a structure of two factors: positive social and curiosity/stress.

RESULTS

The confrmatory factor analysis (CFA) shows that the two-factor model of the TTSS has the ftting indices χ2/df = 2.35, RMSEA = 0.06, and CFI = 0.99, which are better than those of its single-factor model. The total scores of the TTSS, positive social, and curiosity/stress are positively correlated with the scores of Pros, ASCOS, TAS, and Dis of SSS but negatively correlated with the Cons, hereby exhibiting good criterion-related validity. The internal consistency coefcient of the TTSS is 0.89, and the retest reliability is 0.90.

CONCLUSION

Therefore, the TTSS has good reliability and validity for Chinese adolescents and can be used as an efective tool to evaluate adolescents' smoking temptations in China.

Decisional Balance of Smoking and Planning to Quit Smoking: A Moderated Mediation Model among Chinese Male Smokers

Decisional balance in quitting smoking involves positive and negative attitudes toward smoking. This study explored the relationship between the decisional balance of smoking and planning to quit smoking, and examined the mediating role of willingness to quit smoking and the moderating role of social support. A questionnaire survey was conducted among 326 daily male smokers from China in 2016, including the decisional balance of smoking, willingness to quit smoking, social support, planning to quit, and nicotine dependence. The results showed: (1) willingness to quit smoking mediated the relationship between the decisional balance of smoking and planning to quit smoking; (2) the relationship between the decisional balance of smoking and planning to quit smoking was moderated by emotional support rather than instrumental support. Smokers with a higher level of emotional support for quitting smoking were more likely to progress to planning to quit smoking, while this relationship was not found among smokers with a lower level of emotional support. These findings suggested that smokers' willingness to quit smoking would be key to promoting their planning to quit. Meanwhile, the dynamic process of planning to quit smoking was moderated by emotional support from others.

Tobacco Use Status and Temptation to Try E-Cigarettes among a Sample of Appalachian Youth

E-cigarettes are commonly used tobacco products among youth populations, including Appalachian youth. However, knowledge of the extent to which tobacco use status relates to temptation to try e-cigarettes is limited. Data from the Youth Appalachian Tobacco Study (n = 1047) were used. Temptation to try e-cigarettes was derived from a 12-item situational inventory. Tobacco use status was defined as never, ever non-e-cigarette, and ever e-cigarette use. A factorial ANOVA was used to estimate the adjusted association between tobacco use status and the e-cigarette use temptation scale. Two-way interaction terms between tobacco use status and gender, and tobacco use status and race/ethnicity, were plotted to depict effect modification. Approximately 10% of youth were ever non-e-cigarette users and 24% were ever e-cigarette users. Never and ever non-e-cigarette user middle schoolers had higher temptation to try e-cigarettes than their high school counterparts. The same relationship was found among never and ever e-cigarette users living in households with tobacco users. The ANOVA results suggest a positive, monotonic relationship between tobacco use status and temptation to try e-cigarettes, and that the adjusted group means differ by gender and race/ethnicity. The findings can inform tobacco prevention interventions for youth at higher risk for e-cigarette use, especially youth who have not yet tried e-cigarettes.

Using Relational Agents to Promote Exercise and Sun Protection: Assessment of Participants' Experiences With Two Interventions

BACKGROUND

Relational agents (RAs) are electronic computational figures designed to engage participants in the change process. A recent study, Project RAISE, tested the effectiveness of RAs, combined with existing computer-based interventions to increase regular exercise and sun protection behaviors. Results showed these interventions can be effective but need further development.

OBJECTIVE

The purpose of this study was to examine participants' experiences using RAs to increase participant engagement and promote behavior change .

METHODS

A qualitative approach was primarily utilized. A 25-question interview guide assessed different components of participants' experiences with the intervention, including motivation, engagement, satisfaction or dissatisfaction, quality of their interaction with the RA, and behavior change. Quantitative assessment of satisfaction was based on a scale of 1 to 10, with 1 representing least satisfied and 10 representing most satisfied. A summative analytic approach was used to assess individuals' qualitative responses. A single analysis of variance (ANOVA) examined levels of satisfaction by gender.

RESULTS

Of the original 1354 participants enrolled in Project RAISE, 490 of 1354 (36%) were assigned to the RA group. A sample of 216 out of 490 (44%) participants assigned to the RA group completed the interventions, and follow-up assessments were contacted to participate in the semistructured interview. A total of 34 out of 216 (16%) completed the interview. Participants were motivated by, and satisfied with, the intervention. Participants viewed the RA as supportive, informative, caring, and reported positive behavior change in both exercise and sun protection. Some participants (15/34, 44%) noted the RA was less judgmental and less "overbearing" compared with a human counselor; other participants (12/34, 35%) said that the interaction was sometimes repetitive or overly general. The majority of participants (22/34, 65%) viewed the RA as an important contributor to their behavior change for exercise, sun protection, or both. Levels of satisfaction ranged between 7 and 10. There were no gender differences noted in levels of satisfaction (P=.51).

CONCLUSIONS

RAs provide an innovative and attractive platform to increase exercise and sun protection behaviors and potentially other health behaviors.