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Cao J, Feng H, Lim Y, Kodama K, Zhang S. How Social Influence Promotes the Adoption of Mobile Health among Young Adults in China: A Systematic Analysis of Trust, Health Consciousness, and User Experience. Behav Sci (Basel) 2024; 14:498. [PMID: 38920829 PMCID: PMC11200938 DOI: 10.3390/bs14060498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 06/11/2024] [Accepted: 06/12/2024] [Indexed: 06/27/2024] Open
Abstract
As mobile health (mHealth) offers several advantages in healthcare, researchers are exploring the motivational factors for its adoption. However, few studies have elucidated the complex relationship between social influence and behavioral intentions to adopt mHealth among young adults in China. This study explored the impact of social influence on young adults' behavioral intentions to adopt mHealth, the mediating roles of trust and health consciousness, and the moderating effect of mHealth user experience on the relationship between the predictors. In total, 300 valid responses were collected from a university in China, and a research model was developed. The partial least squares structural equation modeling method was used to verify the relationship between the main research variables. mHealth adoption behavioral intentions among young adults were significantly positively impacted by social influence; it indirectly increased mHealth adoption behavioral intentions by positively affecting trust and health consciousness. mHealth use weakened the positive impact of social influence on trust and health consciousness, while user experience positively moderated the relationship between health consciousness and behavioral intentions. Trust and health consciousness play important roles in the complex multivariate relationships between social influence and behavioral intentions to adopt mHealth. Future research should consider the moderating role of the mHealth user experience. These findings enrich the mHealth technology acceptance theory framework and provide specific guidance strategies for marketing mHealth applications.
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Affiliation(s)
- Jianfei Cao
- College of Business Administration, Ritsumeikan University, 2-150 Iwakura-cho, Ibaraki 567-8570, Osaka, Japan; (J.C.); (Y.L.)
| | - Hanlin Feng
- Graduate School of Technology Management, Ritsumeikan University, Ibaraki 567-8570, Osaka, Japan;
| | - Yeongjoo Lim
- College of Business Administration, Ritsumeikan University, 2-150 Iwakura-cho, Ibaraki 567-8570, Osaka, Japan; (J.C.); (Y.L.)
| | - Kota Kodama
- Faculty of Data Science, Nagoya City University, Nagoya 467-8501, Aichi, Japan;
| | - Shuo Zhang
- School of Management, Harbin Institute of Technology, Harbin 150006, China
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Mersha AG, Bryant J, Rahman T, McGuffog R, Maddox R, Kennedy M. What Are the Effective Components of Group-Based Treatment Programs For Smoking Cessation? A Systematic Review and Meta-Analysis. Nicotine Tob Res 2023; 25:1525-1537. [PMID: 37104053 PMCID: PMC10439487 DOI: 10.1093/ntr/ntad068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 03/12/2023] [Accepted: 04/26/2023] [Indexed: 04/28/2023]
Abstract
INTRODUCTION There is significant variation in the format and delivery of group-based smoking cessation programs. To guide research and healthcare program implementation, it is important to understand the active components of interventions. AIMS AND METHODS This review aimed to (1) identify behavior change techniques (BCTs) used in effective group-based smoking cessation interventions, (2) determine the effectiveness of group-based smoking cessation interventions on smoking cessation at 6-month follow-up, and (3) identify the behavior change techniques (BCTs) related to effective group-based smoking cessation. The following databases were searched in January 2000 and March 2022: MEDLINE, EMBASE, CINAHL, PsycINFO, The Cochrane Library, and Web of Science. BCTs used in each study were extracted using the BCT Taxonomy. Studies that included identified BCTs were computed, and meta-analyses were conducted to evaluate smoking cessation at 6-month follow-up. RESULTS A total of 28 BCTs were identified from 19 randomized controlled trials. Studies included an average of 5.42 ± 2.0 BCTs. The most frequent BCTs were "information about health consequences" and "problem solving." The pooled 6-month smoking cessation was higher in the group-based intervention group (OR = 1.75, 95% CI = 1.12 to 2.72, p <.001). Inclusion of the following four BCTs: "Problem solving," "Information about health Consequences," "Information about social and environmental consequences," and "Reward (outcome)" were found to be significantly associated with increased rate of 6-month smoking cessation. CONCLUSIONS Group-based smoking cessation interventions doubles the rate of smoking cessation at 6-month follow-up. Implementing group-based smoking cessation programs, that incorporate multiple BCTs, is recommended for an effective smoking cessation care. IMPLICATIONS Group-based smoking cessation programs improves smoking cessation outcomes in clinical trials. There is a need to incorporate effective individual BCTs techniques to enhance smoking cessation treatment outcomes. A robust evaluation is required to assess the effectiveness of group-based cessation programs in real world settings. There is also a need to consider the differential effectiveness of group-based programs and BCT impacts on populations, for example, indigenous peoples.
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Affiliation(s)
- Amanual Getnet Mersha
- College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Jamie Bryant
- College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Tabassum Rahman
- Centre for Epidemiology and Biostatistics, University of Melbourne, VIC, Australia
| | - Romany McGuffog
- College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
| | - Raglan Maddox
- National Centre for Epidemiology and Public Health, Australian National University, Canberra, ACT, Australia
| | - Michelle Kennedy
- College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
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Alduraywish SA, Alnofaie MF, Alrajhi BF, Balsharaf FA, Alblaihed SS, Alsowigh AA, Alotaibi WS, Aldakheel FM. Knowledge, attitude, and beliefs toward group behavior therapy programs among male adults attending smoking cessation clinics, cross-sectional analysis. BMC Public Health 2021; 21:868. [PMID: 33952245 PMCID: PMC8101190 DOI: 10.1186/s12889-021-10924-4] [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: 12/23/2020] [Accepted: 04/19/2021] [Indexed: 11/12/2022] Open
Abstract
Background Group therapy assists individuals in learning many behavioral techniques for smoking cessation and providing each other with mutual support. Group behavior therapy is not routinely provided as a modality of tobacco cessation assistance in tobacco cessation clinics in Saudi Arabia despite it is effectiveness. Therefore, this study aimed to assess the knowledge, attitude, and beliefs toward group behavior therapy programs among male adults who attend smoking cessation clinics and to identify the associated factors. Methods A cross-sectional study was conducted with a targeted sample of 229 males aged 18 and above who were attending smoking cessation clinics. The participants were randomly selected. Data were collected using a paper-based questionnaire. One-way ANOVA and chi-square test were used for statistical analysis. Results Results showed a high percentage of the study participants were in the age group of 21–40 years. Most of them were consuming 10–20 cigarettes per day. Around 79% of the participants had previous attempted to quit smoking. This study demonstrated a deficit in knowledge about group behavior therapy. The mean score for attitude and beliefs was 5.3 out of 11. Multiple factors influenced their attitudes and beliefs, such as previous attempts to quit smoking (p-value < 0.05) and the number of cigarettes used per day (p-value = 0.03). The knowledge was found to be affected by the level of education (p-value = 0.04). Conclusion The study demonstrates a deficit in knowledge about group behavior therapy and it shows that the level of education was associated with the knowledge. Additionally, previous attempts to quit smoking and the number of cigarettes used per day, influenced the participants’ attitude and beliefs toward group behavioral therapy. Increase awareness about the role of group behavior therapy in smoking cessation is required before this method is implemented in the routine practice. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10924-4.
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Affiliation(s)
- Shatha A Alduraywish
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia. .,Prince Sattam bin Abdulaziz Research Chair for Epidemiology and Public Health, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
| | | | | | | | | | - Alaa A Alsowigh
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Wafa S Alotaibi
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Fahad M Aldakheel
- Prince Sattam bin Abdulaziz Research Chair for Epidemiology and Public Health, College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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Akanbi MO, Carroll AJ, Achenbach C, O'Dwyer LC, Jordan N, Hitsman B, Bilaver LA, McHugh MC, Murphy R. The efficacy of smoking cessation interventions in low- and middle-income countries: a systematic review and meta-analysis. Addiction 2019; 114:620-635. [PMID: 30506845 PMCID: PMC6411424 DOI: 10.1111/add.14518] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 09/27/2018] [Accepted: 11/23/2018] [Indexed: 12/28/2022]
Abstract
AIMS To summarize evidence for the efficacy of smoking cessation interventions in low- and middle-income countries (LMICs). DESIGN Systematic review and meta-analysis of randomized controlled trials. SETTING LMICs as defined by the World Bank. PARTICIPANTS Adult current cigarette smokers residing in LMICs. INTERVENTIONS Behavioral and/or pharmacotherapy smoking cessation interventions. MEASUREMENTS PubMed MEDLINE, EMBASE (embase.com), Cochrane Central Register of Controlled Trials (Wiley), PsycINFO (Ebsco), SciELO, WHO Global Index Medicus and Scopus were searched from inception to 4 April 2018. Only studies with at least 6 months of follow-up were included. We used the most rigorous assessment of abstinence reported by each study. Effect sizes were computed from abstracted data. Where possible, a meta-analysis was performed using Mantel-Haenzel random-effect models reporting odds ratios (OR) and 95% confidence intervals (CI). FINDINGS Twenty-four randomized controlled trials were included. Six investigated the efficacy of pharmacological agents. Four trials that compared nicotine replacement therapy (NRT) to placebo found NRT improved cessation rates (n : NRT 546, control 684, OR = 1.76, 95% CI = 1.30-2.77, P < 0.001, I2 = 13%). Eight trials found that behavioral counseling was more effective than minimal interventions (e.g. brief advice); n : Counseling 2941, control 2794, OR = 6.87, 95% CI = 4.18-11.29, P < 0.001, I2 = 67%). There was also evidence of the benefit of brief advice over usual care (n : Brief advice 373, control 355, OR = 2.46, 95% CI = 1.56-3.88, P < 0.001, I2 = 0%). CONCLUSION Nicotine replacement therapy, behavioral counseling and brief advice appear to be effective in aiding smoking cessation in low- and middle-income countries. There is limited rigorous research on other smoking cessation interventions in these regions.
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Affiliation(s)
- Maxwell Oluwole Akanbi
- Health Sciences Integrated PhD Program, Center for Education in Health SciencesInstitute for Public Health and Medicine, Northwestern University Feinberg School of MedicineChicagoILUSA
- Center for Global HealthNorthwestern UniversityChicagoILUSA
| | - Allison Jane Carroll
- Department of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoILUSA
| | - Chad Achenbach
- Center for Global HealthNorthwestern UniversityChicagoILUSA
- Department of Infectious DiseasesNorthwestern University Feinberg School of MedicineChicagoILUSA
| | - Linda Catherine O'Dwyer
- Galter Health Sciences Library and Learning CenterNorthwestern University, Feinberg School of MedicineChicagoILUSA
| | - Neil Jordan
- Health Sciences Integrated PhD Program, Center for Education in Health SciencesInstitute for Public Health and Medicine, Northwestern University Feinberg School of MedicineChicagoILUSA
- Hines VA HospitalHinesILUSA
| | - Brian Hitsman
- Department of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoILUSA
| | - Lucy Ann Bilaver
- Health Sciences Integrated PhD Program, Center for Education in Health SciencesInstitute for Public Health and Medicine, Northwestern University Feinberg School of MedicineChicagoILUSA
| | - Megan Colleen McHugh
- Health Sciences Integrated PhD Program, Center for Education in Health SciencesInstitute for Public Health and Medicine, Northwestern University Feinberg School of MedicineChicagoILUSA
| | - Robert Murphy
- Center for Global HealthNorthwestern UniversityChicagoILUSA
- Department of Infectious DiseasesNorthwestern University Feinberg School of MedicineChicagoILUSA
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Abstract
OBJECTIVES China is the world's largest tobacco consumer and its adolescent smoking rate is increasing. Smoking interventions among high school students are limited. The aim of this study was to deliver and evaluate a brief theory-based smoking intervention in China, with a focus on anti-smoking cognitions. METHODS The intervention was based on the constructs of an extended theory of planned behavior and life skills training. Using class-level randomization sampling, 106 tenth graders from two high schools in Kunming, China received a four-session intervention; 101 students were assigned as control group members. Surveys were conducted at three time-points (1 week before the intervention, 1 week post-intervention, and 6 months post-intervention). MANOVA and latent class analysis were used to test the intervention's effectiveness and personal change trajectories over time. RESULTS The intervention failed to change smoking behavior, intention or willingness, but improved anti-smoking attitudes and perceived control over smoking. Skills showed a general enhancement, consistent with participants' qualitative feedback. Trajectories of smoking behavior, intention, and willingness all assumed two distinct but constant latent classes independent of the intervention. CONCLUSIONS This study suggests that addressing attitudinal and control beliefs among adolescents and building on assertiveness via additional strategies in life skills such as appropriate refusal skills may be beneficial. The absence of a successful change in subjective norm should be a focus for future anti-smoking programs in China.
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Affiliation(s)
- Xiang Zhao
- a School of Psychology and Counselling, Institute of Health and Biomedical Innovation , Queensland University of Technology , Brisbane , Australia
| | - Katherine M White
- a School of Psychology and Counselling, Institute of Health and Biomedical Innovation , Queensland University of Technology , Brisbane , Australia
| | - Ross McD Young
- b Faculty of Health, Institute of Health and Biomedical Innovation , Queensland University of Technology , Brisbane , Australia
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Predicting the Time Spent Playing Computer and Mobile Games among Medical Undergraduate Students Using Interpersonal Relations and Social Cognitive Theory: A Cross-Sectional Survey in Chongqing, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15081664. [PMID: 30082624 PMCID: PMC6121282 DOI: 10.3390/ijerph15081664] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 07/30/2018] [Accepted: 08/04/2018] [Indexed: 12/29/2022]
Abstract
Background: Computer and mobile games are widely used among undergraduate students worldwide, especially in China. Our objective was to predict the time spent playing computer and mobile games based on interpersonal relations and social cognitive theory constructs (i.e., expectation, self-efficacy, and self-control). Methods: The cross-sectional survey was conducted in two medical universities using a sample of 1557 undergraduate students recruited by cluster sampling. The five-point Likert questionnaire was jointly developed by researchers from Chongqing Medical University and Jackson State University. Results: Approximately 30% and 70% of the students played computer and mobile games, respectively. The daily times spent by participants on computer games were 25.61 ± 73.60 min (weekdays) and 49.96 ± 128.60 min (weekends), and 66.07 ± 154.65 min (weekdays) and 91.82 ± 172.94 min (weekends) on mobile games. Students with high scores of interpersonal relations but low scores of self-efficacy spent prolonged time playing computer games on weekdays and weekends (p < 0.05 for all). Students with low scores of expectation spent prolonged time playing computer games on weekdays (p < 0.05). Students with high scores of interpersonal relations but low scores of self-efficacy and self-control spent prolonged time playing mobile games on weekdays and weekends (p < 0.05 for all). Conclusions: The prevalence and duration of playing mobile games were higher than those of playing computer games among medical undergraduate students in Chongqing, China. This study determined the interpersonal relations, self-efficacy, self-control, and expectation of the students at the time of playing computer and mobile games. Future studies may consider studying the interaction among game-related behaviours, environments, and personality characteristics.
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Predicting Physical Activity and Healthy Nutrition Behaviors Using Social Cognitive Theory: Cross-Sectional Survey among Undergraduate Students in Chongqing, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14111346. [PMID: 29113089 PMCID: PMC5707985 DOI: 10.3390/ijerph14111346] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 10/30/2017] [Accepted: 11/01/2017] [Indexed: 12/31/2022]
Abstract
(1) Background: Generally suggested public health measures to reduce obesity were to limit television (TV) viewing, enhance daily physical activities, enable the consumption of fruit and vegetables, and reduce sugar-sweetened beverage intake. This study analyzed the extent to which selected social cognitive theory constructs can predict these behaviors among Chinese undergraduate students. (2) Methods: This cross-sectional study included 1976 undergraduate students from six universities in Chongqing, China. A self-administered five-point Likert common physical activity and nutrition behavior scale based on social cognitive theory was utilized. (3) Results: This study included 687 (34.77%) males and 1289 (65.23%) females. A total of 60.14% of the students engaged in exercise for less than 30 min per day. Approximately 16.5% of the participants spent at least 4 h watching TV and sitting in front of a computer daily. Approximately 79% of the participants consumed less than five cups of fruit and vegetables daily. Undergraduate students who had high self-efficacy scores had more leisure time physical activities. Those who have high expectation scores had considerable time watching TV and sitting in front of a computer. Undergraduate students who had high expectation and self-efficacy scores had substantially low consumption of sugar-sweetened beverages. Those who had high self-efficacy scores consumed considerable amounts of fruit and vegetables. Furthermore, the type of university, BMI group, gender, age, lack of siblings, and grade level were associated with the aforementioned four behaviors. (4) Conclusion: Physical inactivity and unhealthy nutrition behaviors are common among undergraduate students. This study used social cognitive theory to provide several implications for limiting the TV viewing, enhancing daily physical activities, consuming fruit and vegetables, and reducing sugar-sweetened beverage intake among undergraduate students.
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Beeson ET, Whitney JM, Peterson HM. The Development of a Collegiate Recovery Program: Applying Social Cognitive Theory within a Social Ecological Framework. AMERICAN JOURNAL OF HEALTH EDUCATION 2017. [DOI: 10.1080/19325037.2017.1317304] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Abstract
BACKGROUND Group therapy offers individuals the opportunity to learn behavioural techniques for smoking cessation, and to provide each other with mutual support. OBJECTIVES To determine the effect of group-delivered behavioural interventions in achieving long-term smoking cessation. SEARCH METHODS We searched the Cochrane Tobacco Addiction Group Specialized Register, using the terms 'behavior therapy', 'cognitive therapy', 'psychotherapy' or 'group therapy', in May 2016. SELECTION CRITERIA Randomized trials that compared group therapy with self-help, individual counselling, another intervention or no intervention (including usual care or a waiting-list control). We also considered trials that compared more than one group programme. We included those trials with a minimum of two group meetings, and follow-up of smoking status at least six months after the start of the programme. We excluded trials in which group therapy was provided to both active therapy and placebo arms of trials of pharmacotherapies, unless they had a factorial design. DATA COLLECTION AND ANALYSIS Two review authors extracted data in duplicate on the participants, the interventions provided to the groups and the controls, including programme length, intensity and main components, the outcome measures, method of randomization, and completeness of follow-up. The main outcome measure was abstinence from smoking after at least six months follow-up in participants smoking at baseline. We used the most rigorous definition of abstinence in each trial, and biochemically-validated rates where available. We analysed participants lost to follow-up as continuing smokers. We expressed effects as a risk ratio for cessation. Where possible, we performed meta-analysis using a fixed-effect (Mantel-Haenszel) model. We assessed the quality of evidence within each study and comparison, using the Cochrane 'Risk of bias' tool and GRADE criteria. MAIN RESULTS Sixty-six trials met our inclusion criteria for one or more of the comparisons in the review. Thirteen trials compared a group programme with a self-help programme; there was an increase in cessation with the use of a group programme (N = 4395, risk ratio (RR) 1.88, 95% confidence interval (CI) 1.52 to 2.33, I2 = 0%). We judged the GRADE quality of evidence to be moderate, downgraded due to there being few studies at low risk of bias. Fourteen trials compared a group programme with brief support from a health care provider. There was a small increase in cessation (N = 7286, RR 1.22, 95% CI 1.03 to 1.43, I2 = 59%). We judged the GRADE quality of evidence to be low, downgraded due to inconsistency in addition to risk of bias. There was also low quality evidence of benefit of a group programme compared to no-intervention controls, (9 trials, N = 1098, RR 2.60, 95% CI 1.80 to 3.76 I2 = 55%). We did not detect evidence that group therapy was more effective than a similar intensity of individual counselling (6 trials, N = 980, RR 0.99, 95% CI 0.76 to 1.28, I2 = 9%). Programmes which included components for increasing cognitive and behavioural skills were not shown to be more effective than same-length or shorter programmes without these components. AUTHORS' CONCLUSIONS Group therapy is better for helping people stop smoking than self-help, and other less intensive interventions. There is not enough evidence to evaluate whether groups are more effective, or cost-effective, than intensive individual counselling. There is not enough evidence to support the use of particular psychological components in a programme beyond the support and skills training normally included.
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Affiliation(s)
- Lindsay F Stead
- University of OxfordNuffield Department of Primary Care Health SciencesRadcliffe Observatory QuarterWoodstock RoadOxfordUKOX2 6GG
| | - Allison J Carroll
- Northwestern University Feinberg School of MedicineDepartment of Preventive Medicine680 N. Lake Shore DriveChicagoIllinoisUSA60611
| | - Tim Lancaster
- University of OxfordNuffield Department of Primary Care Health SciencesRadcliffe Observatory QuarterWoodstock RoadOxfordUKOX2 6GG
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Joseph RP, Daniel CL, Thind H, Benitez TJ, Pekmezi D. Applying Psychological Theories to Promote Long-Term Maintenance of Health Behaviors. Am J Lifestyle Med 2016; 10:356-368. [PMID: 28217036 PMCID: PMC5313056 DOI: 10.1177/1559827614554594] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 06/11/2014] [Accepted: 07/01/2014] [Indexed: 11/17/2022] Open
Abstract
Behavioral health theory provides a framework for researchers to design, implement, and evaluate the effects of health promotion programs. However, limited research has examined theories used in interventions to promote long-term maintenance of health behaviors. The purpose of this review was to evaluate the available literature and identify prominent behavioral health theories used in intervention research to promote maintenance of health behaviors. We reviewed theories used in intervention research assessing long-term maintenance (≥ 6 months post-intervention) of physical activity, weight loss, and smoking cessation. Five prominent behavioral theories were referenced by the 34 studies included in the review: Self-Determination Theory, Theory of Planned Behavior, Social Cognitive Theory, Transtheoretical Model, and Social Ecological Model. Descriptions and examples of applications of these theories are provided. Implications for future research are discussed.
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Affiliation(s)
- Rodney P. Joseph
- Rodney P. Joseph, PhD, College of Nursing and Health Innovation, Arizona State University, 500 North Third Street, Phoenix, AZ 85004; e-mail:
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Augustson E, Engelgau MM, Zhang S, Cai Y, Cher W, Li R, Jiang Y, Lynch K, Bromberg JE. Text to Quit China: An mHealth Smoking Cessation Trial. Am J Health Promot 2016; 31:217-225. [PMID: 26730560 DOI: 10.4278/ajhp.140812-quan-399] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To assess the feasibility, acceptability, and efficacy of a text message-based smoking cessation intervention in China. DESIGN Study design was a randomized control trial with a 6-month follow-up assessment of smoking status. SETTING Zhejiang, Heilongjiang, and Shaanxi provinces in China provided the study setting. SUBJECTS A total of 8000 adult smokers in China who used Nokia Life Tools and participated in phase 2 (smoking education via text message) of the study were included. INTERVENTION The high-frequency text contact (HFTC) group received one to three messages daily containing smoking cessation advice, encouragement, and health education information. The low-frequency text contact (LFTC) group received one weekly message with smoking health effects information. MEASURES Our primary outcome was smoking status at 0, 1, 3, and 6 months after intervention. Secondary outcomes include participant perceptions of the HFTC intervention, and factors associated with smoking cessation among HFTC participants. ANALYSIS Descriptive and χ2 analyses were conducted to assess smoking status and acceptability. Factors associated with quitting were assessed using multiple logistic regression analyses. RESULTS Quit rates were high in both the HFTC and LFTC groups (HFTC: 0 month, 27.9%; 1 month, 30.5%; 3 months, 26.7%; and 6 months, 27.7%; LFTC: 0 month, 26.7%; 1 month, 30.4%; 3 months, 28.1%; and 6 months, 27.7%), with no significant difference between the two groups in an intent-to-treat analysis. Attitudes toward the HFTC intervention were largely positive. CONCLUSION Our findings suggest that a text message-based smoking cessation intervention can be successfully delivered in China and is acceptable to Chinese smokers, but further research is needed to assess the potential impact of this type of intervention.
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Affiliation(s)
- Erik Augustson
- 1 Tobacco Control Research Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Michael M Engelgau
- 2 Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Shu Zhang
- 3 Global Assistance Network, International SOS, Beijing, China
| | - Ying Cai
- 2 Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Richun Li
- 2 Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Yuan Jiang
- 5 Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
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Wu L, He Y, Jiang B, Zuo F, Liu Q, Zhang L, Zhou C, Liu M, Chen H. Relationship between education levels and booster counselling sessions on smoking cessation among Chinese smokers. BMJ Open 2015; 5:e007885. [PMID: 26246076 PMCID: PMC4538246 DOI: 10.1136/bmjopen-2015-007885] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Although various effective interventions are available to help individuals quit smoking, the effect of educational levels on cessation rates has rarely been studied, and of the few intervention studies on this topic, the results have been conflicting. DESIGN AND SETTING From October 2008 to August 2013, a partly retrospective non-randomised study was conducted in a smoking cessation clinic of a large general hospital in Beijing, China. PARTICIPANTS In total, 547 Chinese smokers who sought treatment were divided into two groups: a face-to-face counselling group (FC, n=149) and an FC group subjected to four telephone follow-up sessions (FCF, n=398). OUTCOMES We evaluated self-reported cessation rates by day 7 and after 6 and 12 months and stratified the two groups by education levels. RESULTS The 7-day and 6-month and 12-month continuous cessation rates of smokers of low education levels in the FC group at the time of the 12-month follow-up were 12.5%, 7.1% and 7.1%, respectively, which were lower than those of the highly educated smokers (16.1%, 12.9% and 9.7%, respectively). The results were opposite for the FCF group. The corresponding results for the highly educated smokers of the FCF group were 25.0%, 17.2% and 10.3%, respectively, which were lower than those for the smokers of low education levels (28.3%, 22.9% and 18.1%, respectively). However, significant differences were observed only among the FCF group participants who had experienced 12 months of continuous abstinence, and the crude OR for these individuals was recorded at 0.52 (0.29 to 0.93), p=0.03. A stepwise logistic regression showed that education levels may play a role in various intervention methods. Being married and higher Fagerström test scores were also predictors of cessation tendencies. CONCLUSIONS Education levels may affect the benefits of booster counselling sessions on smoking cessation among Chinese smokers.
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Affiliation(s)
- Lei Wu
- Department of Epidemiology, Institute of Geriatrics, Chinese People's Liberation Army General Hospital, Beijing, China
- Beijing Key Laboratory of Aging and Geriatrics, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Yao He
- Department of Epidemiology, Institute of Geriatrics, Chinese People's Liberation Army General Hospital, Beijing, China
- Beijing Key Laboratory of Aging and Geriatrics, Chinese People's Liberation Army General Hospital, Beijing, China
- State Key Laboratory of Kidney Disease, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Bin Jiang
- Department of Acupuncture, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Fang Zuo
- Department of Acupuncture, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Qinghui Liu
- Department of Respiration, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Li Zhang
- Department of Rehabilitation, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Changxi Zhou
- Department of Respiration, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Miao Liu
- Department of Epidemiology, Institute of Geriatrics, Chinese People's Liberation Army General Hospital, Beijing, China
- Beijing Key Laboratory of Aging and Geriatrics, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Hongyan Chen
- Department of Epidemiology, Institute of Geriatrics, Chinese People's Liberation Army General Hospital, Beijing, China
- Beijing Key Laboratory of Aging and Geriatrics, Chinese People's Liberation Army General Hospital, Beijing, China
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Wang J, Li C, Jia C, Liu Y, Liu J, Yan X, Fang Y. Smoking, smoking cessation and tobacco control in rural China: a qualitative study in Shandong Province. BMC Public Health 2014; 14:916. [PMID: 25190269 PMCID: PMC4169812 DOI: 10.1186/1471-2458-14-916] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Accepted: 08/29/2014] [Indexed: 11/10/2022] Open
Abstract
Background Smoking prevalence is high in China and even higher among rural residents. The aims of this study were: 1) to gain insights into the motivations of tobacco use and barriers to smoking cessation among rural village residents; 2) to understand the current tobacco control measures in the rural villages and barriers encountered or perceived for implementation. Methods Qualitative semi-structured face-to-face interviews and focus group discussions were conducted of 59 rural villagers including 37 village residents, 10 village leaders and 12 village doctors in three counties in Shandong Province, China. Results Smoking initiation was most often out of curiosity when seeing others smoke, but pressure from cigarette sharing and gifting custom was the major barrier to smoking cessation. The most important reason for quitting successfully was a detrimental health problem. Although many attempted to quit at the advice of other family members, relapses were common and few were able to quit completely and for long-term unless accompanied by significant health issues. Although doctor’s advice to quit is effective, many doctors do not offer advice to all patients. There is a lack of true understanding of the harm of smoking and second-hand smoking among the villagers and a lack of access to and knowledge of effective smoking cessation tools among both smokers and village doctors. Tobacco control activities at villages were rare and infrequent. Conclusions This study highlighted the need to develop tobacco control measures that reflect the unique culture in rural China. Smoking cessation measures are not likely to achieve large scale effect unless the prevailing cigarette sharing and gifting custom is drastically changed. More educations of the hazards of smoking and second-hand smoking to village residents and educations of effective smoking cessation treatment to both village residents and healthcare providers are needed.
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Affiliation(s)
| | - Chenghui Li
- Division of Pharmaceutical Evaluation and Policy, University of Arkansas for Medical Sciences Collage of Pharmacy, 4301 West Markham Street, Slot #522, Little Rock, AR 72205, USA.
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14
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Wichtige, durch Vektoren übertragene Infektionskrankheiten beim Menschen in Deutschland. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2014; 57:557-67. [DOI: 10.1007/s00103-013-1925-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Kim SS, Chen W, Kolodziej M, Wang X, Wang VJ, Ziedonis D. A systematic review of smoking cessation intervention studies in China. Nicotine Tob Res 2012; 14:891-9. [PMID: 22249687 DOI: 10.1093/ntr/ntr289] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION China has the highest number of tobacco smokers among the world's nations; however, no systematic review has been conducted of clinical trials on the efficacy of smoking cessation interventions in China. This paper summarizes findings of studies in order to compare the effect of pharmacotherapy, counseling, and Traditional Chinese Medicine (TCM) approaches on the abstinence rate. METHODS Clinical trials of smoking cessation interventions published in English or Chinese were extracted from an electronic search of PubMed and WanFang databases. The search yielded 234 studies from the PubMed and 78 studies from the WanFang. RESULTS Twenty-nine studies were included in this review. Of these, 11 (37.9%) were randomized controlled trials (RCTs) that assessed the following approaches: counseling (5 studies), TCM (3 studies), pharmacotherapy (1 study), a combination of pharmacotherapy and counseling (1 study), and physician advice (1 study). Pharmacotherapy alone or in combination with counseling generally resulted in a higher abstinence rate than counseling alone. TCM techniques such as acupuncture and ear point seed pressure yielded a much higher abstinence rate than pharmacotherapy and counseling. Findings are inconclusive, however, because most of the TCM studies were noncontrolled trials and did not provide a definition of "abstinence." Findings on the effectiveness of physician advice to quit smoking were also inconclusive. CONCLUSIONS A review of smoking cessation studies revealed that pharmacotherapy was effective in China. More RCTs of TCM approaches and physician advice are needed with long-term follow-up assessments and biochemical verification of self-reported abstinence before these approaches are adopted as evidence-based smoking cessation interventions in China.
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Affiliation(s)
- Sun S Kim
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA.
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Houston TK, Cherrington A, Coley HL, Robinson KM, Trobaugh JA, Williams JH, Foster PH, Ford DE, Gerber BS, Shewchuk RM, Allison JJ. The art and science of patient storytelling-harnessing narrative communication for behavioral interventions: the ACCE project. JOURNAL OF HEALTH COMMUNICATION 2011; 16:686-97. [PMID: 21541875 DOI: 10.1080/10810730.2011.551997] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Narrative communication is an emerging form of persuasive communication used in health education to solicit actual patient stories. Eliciting a narrative is an open-ended process and may or may not map to desired intervention objectives or underlying behavioral constructs. In addition, incorporating actual, unscripted narratives into multimedia interventions is challenging. The authors evaluated a protocol of editing narratives for a multimedia intervention to promote smoking cessation in the African American community that maintains fidelity to the original message and was related to behavioral constructs from social cognitive theory. The authors used four steps: (a) narrative collection (videotaping), (b) narrative review (rating of content), (c) narrative editing (documentary style), and (d) pilot testing (usability and assessment of transportation). The authors videotaped 50 personal smoking cessation narratives. After coding for presence of theoretical constructs, perceived risks of smoking (present in 53% of narratives) was the most common related behavioral construct. Four narratives were chosen for inclusion in the DVD. Pilot testing showed viewers reported high level of transportation into the narrative. The authors found that some behavioral constructs were rare and difficult to solicit in this population but that the final product was engaging to the viewers. Lessons learned may be useful for other video-based behavioral interventions that incorporate personal narratives.
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Affiliation(s)
- Thomas K Houston
- The Center for Health Quality, Outcomes & Economic Research (CHQOER), Bedford Veterans Administration Medical Center, Bedford, Massachusetts, USA.
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Michie S, Churchill S, West R. Identifying evidence-based competences required to deliver behavioural support for smoking cessation. Ann Behav Med 2011; 41:59-70. [PMID: 20936389 DOI: 10.1007/s12160-010-9235-z] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND No systematic basis has yet been published for specifying competences needed to underpin behavioural support for smoking cessation. PURPOSE The purpose of this study was to develop and apply a system for identifying competences required for the delivery of individual and group-based behavioural support for smoking cessation. METHODS Sets of recommended competences for behavioural support were identified from a range of guidance documents. Where possible, these were compared with ones based on behaviour change techniques identified within behavioural support programmes found to be effective in randomised controlled trials (RCTs) and, for individual behavioural support, ones associated with higher success rates in the English Stop Smoking Services. RESULTS Ninety-four competences were identified (71 individual and 23 additional group competences), of which 59 were cited in at least two guidance documents (51 and 8, respectively). Fourteen of the individual competences and three of the group competences were supported by RCT evidence and, for individual competences, nine were supported by evidence from the services. CONCLUSIONS It is possible to identify competences recommended for behavioural support for smoking cessation and subsets supported by different types of evidence. This approach can form the basis for the development of assessment and training of stop smoking practitioners and is currently doing so in a national programme in England. With further research, the list of evidence-based competences is likely to be extended.
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Affiliation(s)
- Susan Michie
- NHS Centre for Smoking Cessation and Training, University College London, UK.
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Webb TL, Sniehotta FF, Michie S. Using theories of behaviour change to inform interventions for addictive behaviours. Addiction 2010; 105:1879-92. [PMID: 20670346 DOI: 10.1111/j.1360-0443.2010.03028.x] [Citation(s) in RCA: 138] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS This paper reviews a set of theories of behaviour change that are used outside the field of addiction and considers their relevance for this field. METHODS Ten theories are reviewed in terms of (i) the main tenets of each theory, (ii) the implications of the theory for promoting change in addictive behaviours and (iii) studies in the field of addiction that have used the theory. An augmented feedback loop model based on Control Theory is used to organize the theories and to show how different interventions might achieve behaviour change. RESULTS Briefly, each theory provided the following recommendations for intervention: Control Theory: prompt behavioural monitoring, Goal-Setting Theory: set specific and challenging goals, Model of Action Phases: form 'implementation intentions', Strength Model of Self-Control: bolster self-control resources, Social Cognition Models (Protection Motivation Theory, Theory of Planned Behaviour, Health Belief Model): modify relevant cognitions, Elaboration Likelihood Model: consider targets' motivation and ability to process information, Prototype Willingness Model: change perceptions of the prototypical person who engages in behaviour and Social Cognitive Theory: modify self-efficacy. CONCLUSIONS There are a range of theories in the field of behaviour change that can be applied usefully to addiction, each one pointing to a different set of modifiable determinants and/or behaviour change techniques. Studies reporting interventions should describe theoretical basis, behaviour change techniques and mode of delivery accurately so that effective interventions can be understood and replicated.
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Affiliation(s)
- Thomas L Webb
- Department of Psychology, The University of Sheffield, Western Bank, Sheffield, UK.
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Effectiveness of a mobile smoking cessation service in reaching elderly smokers and predictors of quitting. BMC Geriatr 2008; 8:25. [PMID: 18837985 PMCID: PMC2570661 DOI: 10.1186/1471-2318-8-25] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2008] [Accepted: 10/06/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Different smoking cessation programmes have been developed in the last decade but utilization by the elderly is low. We evaluated a pilot mobile smoking cessation service for the Chinese elderly in Hong Kong and identified predictors of quitting. METHODS The Mobile Smoking Cessation Programme (MSCP) targeted elderly smokers (aged 60 or above) and provided service in a place that was convenient to the elderly. Trained counsellors provided individual counselling and 4 week's free supply of nicotine replacement therapy (NRT). Follow up was arranged at 1 month by face-to-face and at 3 and 6 months by telephone plus urinary cotinine validation. A structured record sheet was used for data collection. The service was evaluated in terms of process, outcome and cost. RESULTS 102 governmental and non-governmental social service units and private residential homes for the elderly participated in the MSCP. We held 90 health talks with 3266 elderly (1140 smokers and 2126 non-smokers) attended. Of the 1140 smokers, 365 (32%) received intensive smoking cessation service. By intention-to-treat, the validated 7 day point prevalence quit rate was 20.3% (95% confidence interval: 16.2%-24.8%). Smoking less than 11 cigarettes per day and being adherent to NRT for 4 weeks or more were significant predictors of quitting. The average cost per contact was US$54 (smokers only); per smoker with counselling: US$168; per self-reported quitter: US$594; and per cotinine validated quitter: US$827. CONCLUSION This mobile smoking cessation programme was acceptable to elderly Chinese smokers, with quit rate comparable to other comprehensive programmes in the West. A mobile clinic is a promising model to reach the elderly and probably other hard to reach smokers.
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Abstract
BACKGROUND Group therapy offers individuals the opportunity to learn behavioural techniques for smoking cessation, and to provide each other with mutual support. OBJECTIVES We aimed to determine the effects of smoking cessation programmes delivered in a group format compared to self-help materials, or to no intervention; to compare the effectiveness of group therapy and individual counselling; and to determine the effect of adding group therapy to advice from a health professional or to nicotine replacement. We also aimed to determine whether specific components increased the effectiveness of group therapy. We aimed to determine the rate at which offers of group therapy are taken up. SEARCH STRATEGY We searched the Cochrane Tobacco Addiction Group Trials Register, with additional searches of MEDLINE and PsycINFO, including the terms behavior therapy, cognitive therapy, psychotherapy or group therapy, in January 2005. SELECTION CRITERIA We considered randomized trials that compared group therapy with self help, individual counselling, another intervention or no intervention (including usual care or a waiting list control). We also considered trials that compared more than one group programme. We included those trials with a minimum of two group meetings, and follow up of smoking status at least six months after the start of the programme. We excluded trials in which group therapy was provided to both active therapy and placebo arms of trials of pharmacotherapies, unless they had a factorial design. DATA COLLECTION AND ANALYSIS We extracted data in duplicate on the participants, the interventions provided to the groups and the controls, including programme length, intensity and main components, the outcome measures, method of randomization, and completeness of follow up. The main outcome measure was abstinence from smoking after at least six months follow up in patients smoking at baseline. We used the most rigorous definition of abstinence in each trial, and biochemically validated rates where available. Subjects lost to follow up were analyzed as continuing smokers. Where possible, we performed meta-analysis using a fixed-effects (Mantel-Haenszel) model. MAIN RESULTS A total of 55 trials met inclusion criteria for one or more of the comparisons in the review. Sixteen studies compared a group programme with a self-help programme. There was an increase in cessation with the use of a group programme (N = 4395, odds ratio (OR) 2.04, 95% confidence interval (CI) 1.60 to 2.60). Group programmes were more effective than no intervention controls (seven trials, N = 815, OR 2.17, 95% CI 1.37 to 3.45). There was no evidence that group therapy was more effective than a similar intensity of individual counselling. There was limited evidence that the addition of group therapy to other forms of treatment, such as advice from a health professional or nicotine replacement, produced extra benefit. There was variation in the extent to which those offered group therapy accepted the treatment. There was limited evidence that programmes which included components for increasing cognitive and behavioural skills and avoiding relapse were more effective than same length or shorter programmes without these components. This analysis was sensitive to the way in which one study with multiple conditions was included. We did not find an effect of manipulating the social interactions between participants in a group programme on outcome. AUTHORS' CONCLUSIONS Group therapy is better for helping people stop smoking than self help, and other less intensive interventions. There is not enough evidence to evaluate whether groups are more effective, or cost-effective, than intensive individual counselling. There is not enough evidence to support the use of particular psychological components in a programme beyond the support and skills training normally included.
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Affiliation(s)
- L F Stead
- Department of Primary Health Care, Oxford University, Old Road Campus, Headington, Oxford, UK, OX3 7LF.
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