Helping adolescents quit smoking:a needs assessment of current and former teen smokers

This study compared the survey responses of 280 current and former adolescent smokers for what they perceived would be helpful (or what had helped) in quitting smoking. The survey was developed from focus groups and was structured using Prochaska and DiClementes Stages of Change health behavior framework. Results showed that former smokers and current smokers in the preparation stage of change shared beliefs about the importance of interpersonal support, those who were contemplating a quit decision worried about obstacles and internal issues, and current smokers not thinking about quitting focused on external rewards. The findings that significant differences exist based on the adolescent smokers Stage of Change imply that this framework can be appropriately applied to this context.

Impact of a patient-centered, computer-based health information/support system

BACKGROUND

Consumer health information systems potentially improve a patient's quality of life and activate patient self-care.

OBJECTIVES

Test a computerized system (CHESS: Comprehensive Health Enhancement Support System), which, in this application, provided HIV-positive patients with information, decision support, and connections to experts and other patients. Would patients given in-home access to computers use the system, improve their quality of life, reduce health-risk behaviors, and use medical services more efficiently?

RESEARCH DESIGN

Randomized controlled trial: CHESS computers in experimental subjects' homes in Madison or Milwaukee, Wisconsin, for 3 or 6 months; controls received no intervention. Subjects were compensated for self-report surveys completed before, during, and after CHESS installation.

SUBJECTS

Of 204 HIV-positive patients recruited (90% male, 84% white, average education some college, and 65% experiencing HIV-related symptoms), 90% completed the study.

MEASURES

Self-reports of quality of life and frequency and duration of use of medical services.

RESULTS

CHESS was used daily with little difference between demographic subgroups. While CHESS was in the home, its users reported quality-of-life improvements: active life, negative emotions, cognitive function, social support, and participation in health care. They also reported spending less time during ambulatory care visits, making more phone calls to providers, and experiencing fewer and shorter hospitalizations.

CONCLUSIONS

A computer-based personal health support system can improve a patient's quality of life and promote more efficient use of health care.

The quality of interactive computer use among HIV-infected individuals

This study examined how HIV-infected individuals used an interactive health software package called CHESS (Comprehensive Health Enhancement Support System). CHESS packages information and support in a variety of ways; the research examined how a subset of users whose posttest scores in a larger randomized trial showed significant improvement in quality of life compared on use patterns of CHESS with those who did not improve. The evidence presented here points to the nature of CHESS use more than it does to the amount of CHESS use. Those whose quality of life improved were among the most involved in their use of CHESS information tools. That is, even though Discussion Group accounted for the majority of all CHESS uses and time spent with the system, total use and Discussion Group use appeared less important than use of the information tools, especially if that use was at least somewhat sustained and involved.

Long-term results of an intensive treatment program for adults and adolescents who stutter

In order to determine the long-term effects of an intensive treatment program, 17 adult and 25 adolescent stutterers were tested 2 or 3 times during a 12- to 24-month post-intensive treatment phase. The results of this study are intended to augment and supplement the growing body of evidence about the effects of intensive treatment programs on adult and adolescent stutterers. Follow-up measures included surprise phone calls to clients at home/work and a self-administered Speech Performance Questionnaire. Careful training of speech raters was undertaken to ensure high reliability of speech measures. Results from the phone call samples indicated that about 69% of the subjects maintained a satisfactory level of post-treatment fluency, with an additional 7% maintaining a level that was judged to be marginally satisfactory. On the self-administered Questionnaire, 80% of the subjects rated their speech fluency as good or fair 12 to 24 months after treatment.

Stuttering: current status of theory and therapy

When people become concerned about stuttering, either their own or their child's, they typically seek help from their family physician or pediatrician. Characteristics and effects of stuttering can help the physician determine whether the child's speech patterns are within normal range or could be early warning signs of stuttering. Referral to a speech-language pathologist should be considered when any of the following are noted: excessive part-word repetitions or sound prolongations; signs of tension, such as lip tremors, facial grimaces, or breath holding associated with speech; indications of embarrassment or apprehension; and a tendency to withdraw from speech opportunities. The authors briefly review theories on the causes of stuttering, describe current therapy, and identify some specialized treatment centres.

Stuttering: recent developments in theory and in therapy

When parents are concerned about the development of stuttering in their child they often consult their pediatrician or family physician. Theories on the development of stuttering are briefly examined in this article, and guidelines are provided to help the physician determine if the child's dysfluencies are within the normal range. Referral to a speech therapist should be considered when any of the following are noted: excessive repetition of the first syllable of words; tremor of the muscles of mouth or jaw, increase in pitch or loudness, or evidence of fear or emotion as the child struggles with a word; evidence that the child avoids certain words or situations; and excessive concern of parents, teachers or the dysfluent individual. Two approaches to therapy, traditional and behavioural, are described. The latter has resulted in significant gains in fluency among stutterers.