scholarly journals Parents' Self-efficacy for Tobacco Exposure Protection and Smoking Abstinence Mediate Treatment Effects on Child Cotinine at 12-Month Follow-up: Mediation Results from the Kids Safe and Smokefree Trial

2019 ◽  
Vol 22 (11) ◽  
pp. 1981-1988
Author(s):  
Bradley N Collins ◽  
Stephen J Lepore ◽  
Jonathan P Winickoff ◽  
David W Sosnowski
Keyword(s):  
Behavior Change ◽  
Tobacco Smoke ◽  
Low Income ◽  
Self Efficacy ◽  
Disease Burden ◽  
Underserved Populations ◽  
Smoking Behavior ◽  
Evidence Based ◽  
Smoking Abstinence ◽  
Behavioral Mechanisms

Abstract Introduction Compared with the general smoking population, low-income smokers face elevated challenges to success in evidence-based smoking cessation treatment. Moreover, their children bear increased disease burden. Understanding behavioral mechanisms related to successful reduction of child tobacco smoke exposure (TSE) could inform future smoking interventions in vulnerable, underserved populations. Methods Smoking parents were recruited from pediatric clinics in low-income communities and randomized into a multilevel intervention including a pediatric clinic intervention framed in best clinical practice guidelines (“Ask, Advise, Refer” [AAR]) plus individualized telephone counseling (AAR + counseling), or AAR + control. Mediation analysis included treatment condition (independent variable), 12-month child cotinine (TSE biomarker, criterion), and four mediators: 3-month end-of-treatment self-efficacy to protect children from TSE and smoking urge coping skills, and 12-month perceived program (intra-treatment) support and bioverified smoking abstinence. Analyses controlled for baseline nicotine dependence, depressive symptoms, child age, and presence of other residential smokers. Results Participants (n = 327) included 83% women and 83% African Americans. Multilevel AAR + counseling was associated with significantly higher levels of all four mediators (ps < .05). Baseline nicotine dependence (p < .05), 3-month self-efficacy (p < .05) and 12-month bioverified smoking abstinence (p < .001) related significantly to 12-month child cotinine outcome. The indirect effects of AAR + counseling intervention on cotinine via self-efficacy for child TSE protection and smoking abstinence (ps < .05) suggested mediation through these pathways. Conclusions Compared with AAR + control, multilevel AAR + counseling improved all putative mediators. Findings suggest that fostering TSE protection self-efficacy during intervention and encouraging parental smoking abstinence may be key to promoting long-term child TSE-reduction in populations of smokers with elevated challenges to quitting smoking. Implications Pediatric harm reduction interventions to protect children of smokers from tobacco smoke have emerged to address tobacco-related health disparities in underserved populations. Low-income smokers experience greater tobacco-related disease burden and more difficulty with smoking behavior change in standard evidence-based interventions than the general population of smokers. Therefore, improving knowledge about putative behavioral mechanisms of smoking behavior change that results in lower child exposure risk could inform future intervention improvements.

scholarly journals Is self-efficacy for smoking abstinence a cause of, or a reflection on, smoking behavior change?

2012 ◽  
Vol 20 (1) ◽  
pp. 56-62 ◽  
Author(s):  
Kenneth A. Perkins ◽  
Craig Parzynski ◽  
Melissa Mercincavage ◽  
Cynthia A. Conklin ◽  
Carolyn A. Fonte
Keyword(s):  
Behavior Change ◽  
Self Efficacy ◽  
Smoking Behavior ◽  
Smoking Abstinence

scholarly journals Perceived Pain and Smoking Interrelations and Expectancies Are Associated With Pain and Smoking Cessation in Individuals With Mobility Impairments

2019 ◽  
Author(s):  
Romano Endrighi ◽  
Nicolle Rueras ◽  
Shira I Dunsiger ◽  
Belinda Borrelli
Keyword(s):  
Chronic Pain ◽  
Smoking Cessation ◽  
Self Efficacy ◽  
Smoking Behavior ◽  
Lower Probability ◽  
Smoking Abstinence ◽  
Cross Sectional ◽  
Mobility Impairments ◽  
Quit Smoking ◽  
Perceived Pain

Abstract Introduction Smoking and pain are highly prevalent among individuals with mobility impairments (MIs; use assistive devices to ambulate). The role of pain-related smoking motives and expectancies in smoking cessation is unknown. We examined cross-sectional and prospective associations between a novel measure of pain-related smoking motives (how smokers with pain perceive their pain and smoking to be interrelated) and pain and smoking behavior in smokers with MI. Methods This is a secondary data analysis of a smoking cessation induction trial (N = 263; 55% female) in smokers with MI. Participants did not have to want to quit to enroll. Pain-related smoking motives and expectancies were assessed at baseline with the pain and smoking inventory (PSI) which measures perceived pain and smoking interrelations in three distinct but related domains (smoking to cope with pain, pain as a motivator of smoking and as a barrier to cessation). Other measures included pain occurrence and interference, nicotine dependence, motivation and self-efficacy to quit smoking, and number of cigarettes per day. Biochemically verified smoking abstinence was assessed at 6 months. Results PSI scores were significantly higher among smokers with chronic pain occurrence compared to occasional and to no occurrence (p < .002) and were associated with greater pain interference (ps < .01) and lower self-efficacy to quit smoking (ps < .01). In prospective analyses adjusted for age, treatment group, and chronic pain, only expectancies of smoking to help cope with pain predicted lower odds of abstinence. Conclusions Targeting expectancies of smoking as a mechanism to cope with pain may be useful in increasing smoking cessation in pain populations. Implications Individuals with MI have a high prevalence of smoking and pain, yet the extent to which this population perceives pain and smoking to be interrelated is unknown. This is the first article to examine prospective associations between a novel measure of perceived pain and smoking interrelations (PSI) and smoking outcomes. The PSI was associated with greater pain and lower self-efficacy for quitting. Prospectively, the PSI subscale tapping into expectancies that smoking help coping with pain predicted a lower probability of smoking abstinence. In smokers with MI, expectancies of smoking as pain-coping mechanism may be an important clinical target.

In Defense of Food Curriculum: A Mixed Methods Outcome Evaluation in Afterschool

2019 ◽  
Vol 46 (4) ◽  
pp. 612-625
Author(s):  
Hiershenee B. Luesse ◽  
Joseph E. Luesse ◽  
Jordan Lawson ◽  
Pamela A. Koch ◽  
Isobel R. Contento
Keyword(s):  
Behavior Change ◽  
Low Income ◽  
Self Efficacy ◽  
Vegetable Intake ◽  
Self Regulation ◽  
Outcome Evaluation ◽  
Processed Foods ◽  
Minimally Processed ◽  
Environmental Barriers ◽  
Psychosocial Mediators

Background. Highly processed foods are inexpensive and abundant in our food supply, nutritionally poor, and disproportionately marketed to minority youth. This study is part of a curriculum development project to develop, implement, and evaluate the In Defense of Food (IDOF) curriculum designed to increase intake of whole/minimally processed foods and decrease intake of highly processed foods in youth. Aims. This pilot outcome evaluation was undertaken to assess initial effectiveness and to provide an in-depth understanding of changes in behavioral outcomes and psychosocial mediators. Methods. We used an explanatory mixed method approach, including a single-arm pretest–posttest of intervention effect, followed by a food rules assessment and in-depth interviews to describe participant responses to the intervention in more detail. The study was conducted in three afterschool classrooms in urban low-income neighborhoods with 32 multiethnic middle-school youth, receiving 10 weekly 2-hour sessions. Results. Two weeks postintervention, there was a large positive significant increase in whole/minimally processed food intake ( p < .01; d = 0.59) and a small decrease in consumption of highly-processed foods ( p = ns; d = 0.06), compared with baseline. Significant increases in psychosocial mediators: Self-efficacy and positive outcomes expectations were seen; others were not significant but changed in the desired direction. Qualitative assessments suggest that the intervention promoted skill building, but environmental barriers made these difficult to use. Discussion. The IDOF curriculum may be most effective for promoting consumption of fruits and vegetables, rather than decreasing intake of highly processed foods. In addition, in this young age-group, short actionable food rules may support self-regulation and behavior change. Conclusion. Among adolescent students in low-income urban neighborhoods, the IDOF afterschool curriculum may help promote self-efficacy and positive outcome expectancies and increase fruit and vegetable intake. Focusing on food processing and using “Food Rules” may be promising to elicit behavior change in youth; however, greater supports are needed to overcome social and environmental barriers.

scholarly journals Promoting Smoke-Free Homes Through Biomarker Feedback Documenting Child Exposure to Tobacco Toxins: Protocol for a Randomized Clinical Trial (Preprint)

2018 ◽  
Author(s):  
Janet Leigh Thomas ◽  
Meredith Schreier ◽  
Xianghua Luo ◽  
Sue Lowry ◽  
Deborah Hennrikus ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Behavior Change ◽  
Randomized Clinical Trial ◽  
Low Income ◽  
Smoking Behavior ◽  
Self Report ◽  
Child Exposure ◽  
Smoking Restrictions ◽  
Tobacco Carcinogen ◽  
Shs Exposure

BACKGROUND Exposure to secondhand smoke (SHS) early in life increases the risk of sudden infant death syndrome (SIDS), asthma, and respiratory illnesses. Since children’s primary exposure to SHS occurs in the home, these most vulnerable members of our society are not fully protected by recent increases in the adoption of smoking bans in public spaces. Although exposure to SHS is a quickly reversible cause of excess morbidity, few low-income homes strictly enforce smoking restrictions. OBJECTIVE This study aims to test a novel approach to motivate the adoption of home smoking restrictions and to eliminate child SHS exposure by providing parents with objective data documenting home SHS exposure and “biomarker feedback” of child ingestion of tobacco toxins, that is, objective, laboratory-based results of assays performed on child urine, documenting levels of nicotine; cotinine; and NNAL (4-[methylnitrosamino]-1-[3-pyridyl]-1-butanol), which is a metabolite of the known tobacco carcinogen NNK (4-[methylnitro-samino]-1-[3-pyridyl]-1-butanone). METHODS From 2011 to 2013, 195 low-income, female smokers with children aged ≤10 years residing in their homes were recruited into a two-arm randomized clinical trial. Participants were assigned to one of two groups: biomarker feedback (n=98) and health education (n=97). In-home assessments were administered at baseline, week 16, and week 26. Children’s home SHS exposure and nicotine, cotinine, and NNAL levels from urine samples, measured through a passive nicotine dosimeter and a surface sample of residual tobacco smoke (ie, thirdhand smoke), were collected at all three time points. Primary outcome was dosimeter-verified, self-reported complete home smoking restrictions at 6 months after randomization. Secondary outcomes included parental self-report of smoking behavior change and child urine tobacco toxin (biomarker) change. RESULTS Data collection and analyses are complete, and the results are being interpreted. CONCLUSIONS The study protocol describes the development of a novel community-based controlled trial designed to examine the efficacy of biomarker feedback documenting home and child exposure to SHS on parental smoking behavior change. INTERNATIONAL REGISTERED REPORT RR1-10.2196/12654

scholarly journals A Goal Setting Intervention Positively Impacts Adolescents’ Dietary Behaviors and Physical Activity Self-Efficacy

2012 ◽  
Vol 7 (4) ◽  
pp. 92-108 ◽  
Author(s):  
Mical Kay Shilts ◽  
Marilyn S. Townsend
Keyword(s):  
Physical Activity ◽  
Behavior Change ◽  
Youth Development ◽  
Goal Setting ◽  
Low Income ◽  
Self Efficacy ◽  
Repeated Measures ◽  
Goal Attainment ◽  
Cognitive Theory ◽  
Dietary Behaviors

The efficacy of a youth development intervention on improving eating and physical activity(PA) self-efficacy, goal attainment scaling, goal effort, and behaviors was examined in a repeated measures, quasi-experimental field trial. Ethnically diverse students (n=64) from a low-income middle school participated in the 10-session intervention driven by the Social Cognitive Theory with a Goal Setting Theory emphasis. Participants, 13-14 years old, made significant changes in dietary behaviors (P=0.03) and PA self-efficacy (P=0.02) after receiving the intervention. Self-efficacy did not mediate dietary behavior change but did mediate the small changes made in PA. Goal effort was not a mediator of behavior change. After the intervention, more participants rated themselves as making one lasting improvement in eating (P

scholarly journals Promoting Smoke-Free Homes Through Biomarker Feedback Documenting Child Exposure to Tobacco Toxins: Protocol for a Randomized Clinical Trial

10.2196/12654 ◽  
2019 ◽  
Vol 8 (10) ◽  
pp. e12654 ◽  
Author(s):  
Janet Leigh Thomas ◽  
Meredith Schreier ◽  
Xianghua Luo ◽  
Sue Lowry ◽  
Deborah Hennrikus ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Behavior Change ◽  
Randomized Clinical Trial ◽  
Low Income ◽  
Smoking Behavior ◽  
Self Report ◽  
Child Exposure ◽  
Smoking Restrictions ◽  
Tobacco Carcinogen ◽  
Shs Exposure

Background Exposure to secondhand smoke (SHS) early in life increases the risk of sudden infant death syndrome (SIDS), asthma, and respiratory illnesses. Since children’s primary exposure to SHS occurs in the home, these most vulnerable members of our society are not fully protected by recent increases in the adoption of smoking bans in public spaces. Although exposure to SHS is a quickly reversible cause of excess morbidity, few low-income homes strictly enforce smoking restrictions. Objective This study aims to test a novel approach to motivate the adoption of home smoking restrictions and to eliminate child SHS exposure by providing parents with objective data documenting home SHS exposure and “biomarker feedback” of child ingestion of tobacco toxins, that is, objective, laboratory-based results of assays performed on child urine, documenting levels of nicotine; cotinine; and NNAL (4-[methylnitrosamino]-1-[3-pyridyl]-1-butanol), which is a metabolite of the known tobacco carcinogen NNK (4-[methylnitro-samino]-1-[3-pyridyl]-1-butanone). Methods From 2011 to 2013, 195 low-income, female smokers with children aged ≤10 years residing in their homes were recruited into a two-arm randomized clinical trial. Participants were assigned to one of two groups: biomarker feedback (n=98) and health education (n=97). In-home assessments were administered at baseline, week 16, and week 26. Children’s home SHS exposure and nicotine, cotinine, and NNAL levels from urine samples, measured through a passive nicotine dosimeter and a surface sample of residual tobacco smoke (ie, thirdhand smoke), were collected at all three time points. Primary outcome was dosimeter-verified, self-reported complete home smoking restrictions at 6 months after randomization. Secondary outcomes included parental self-report of smoking behavior change and child urine tobacco toxin (biomarker) change. Results Data collection and analyses are complete, and the results are being interpreted. Conclusions The study protocol describes the development of a novel community-based controlled trial designed to examine the efficacy of biomarker feedback documenting home and child exposure to SHS on parental smoking behavior change. International Registered Report Identifier (IRRID) RR1-10.2196/12654

scholarly journals The Implementation of Evidence-Based Obesity Education Curricula to Prevent Cancer in a Predominantly Mexican–American Community on the U.S.-Mexico Border

2021 ◽  
Author(s):  
Roy Valenzuela ◽  
Alma Morales ◽  
Jon Sheen ◽  
Sylvia Rangel ◽  
Jennifer J. Salinas
Keyword(s):  
Physical Activity ◽  
Low Income ◽  
Mexican Americans ◽  
Weight Status ◽  
Cognitive Theory ◽  
Underserved Populations ◽  
Evidence Based ◽  
Community Based ◽  
Incidence And Mortality ◽  
Low Income Housing

Abstract Although cancer is the leading cause of death among Mexican-Americans, few community-based programs target obesity reduction as a way to reduce the prevalence of obesity-related cancer in underserved populations. Evidence suggests that obesity correlates with 13 types of cancer. The objective is to provide an overview of evaluation and selection of evidence-based content; details of the implementation process; modifications needed to tailor education programs to specific needs of different target audiences; and demonstrate challenges of implementing a community-based prevention program intended to reduce cancer incidence and mortality in Mexican-Americans. We used the Social Cognitive Theory (SCT) to develop a 10-topic menu of educational classes using elements of multiple evidence-based curricula. Outcome measures for physical activity and nutrition were determined using the International Physical Activity Questionnaire (IPAQ) and the Dietary Screener Questionnaire (DSQ). Weight status was determined using weight, body fat, and body mass index (BMI). To date, 2845 adults received wellness education from our program. Multiple delivery models were used to reach a larger audience; they included a 4-week model, 5-week model, employer model, low-income housing, 1- and 2-h sessions, and clinic encounters. Individuals were given education at multiple community locations including senior centers (14%), churches (0.6%), employers (17.6%), low-income housing (8.2%), community centers (16.6%), clinics (11.5%), and schools (32.5%). Our study indicates that our delivery model is feasible and can disseminate evidence-based obesity education. Further investigation is necessary to assess long-term behavioral change and to assess the most effective model for delivery.

scholarly journals Effectiveness of a Large, Nation-Wide Smoking Abstinence Campaign in the Netherlands: A Longitudinal Study

2019 ◽  
Vol 16 (3) ◽  
pp. 378 ◽  
Author(s):  
Sigrid Troelstra ◽  
Janneke Harting ◽  
Anton Kunst
Keyword(s):  
The Netherlands ◽  
Self Efficacy ◽  
Smoking Habit ◽  
Smoking Behavior ◽  
Habit Strength ◽  
Smoking Abstinence ◽  
Behavioral Determinants ◽  
Quit Smoking ◽  
Quit Attempts ◽  
Related Stress

From 2014, the 28-day smoking abstinence campaign ‘Stoptober’ is held in the Netherlands. Each year, more than 50,000 people participate in what has become a nation-wide collective cessation attempt. This study aims to determine the short-term effects of ‘Stoptober’ on participants’ smoking behavior and behavioral determinants. Stoptober participants completed online surveys before the start of the campaign (n = 6856) and three months later (n = 1127). Descriptive statistics and t-tests were performed to determine changes in smoking and behavioral determinants. Logistic regression analyses were used to identify differences between subgroups. After three months, 71.8% of respondents had quit smoking and consumption was reduced among sustained smokers. Cessation rates were similar for subgroups by age, sex and educational level. Cessation was positively associated with confidence and self-efficacy at baseline and negatively associated with past year quit attempts and addiction level at baseline. For quitters, we found favorable changes in attitude towards cessation related stress, social norms, social pressure to smoke, self-efficacy to quit, smoking habit strength and smoker identity. For sustained smokers, we found favorable changes in attitude towards cessation related stress, self-efficacy and smoking habit strength. These results suggest that an abstinence campaign with a wide reach in a national population may be effective in decreasing smoking prevalence and cigarette consumption among a broad range of participants.

Self-efficacy and barriers to multiple behavior change in low-income African Americans with hypertension

2012 ◽  
Vol 36 (1) ◽  
pp. 75-85 ◽  
Author(s):  
Carol L. Mansyur ◽  
Valory N. Pavlik ◽  
David J. Hyman ◽  
Wendell C. Taylor ◽  
G. Kenneth Goodrick
Keyword(s):  
African Americans ◽  
Behavior Change ◽  
Low Income ◽  
Self Efficacy ◽  
Multiple Behavior Change

scholarly journals Addressing Alzheimer’s Risk in Racially Diverse, Low-Income Older Adults Through Telephone Health Coaching

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 282-282
Author(s):  
Faika Zanjani ◽  
Annie Rhodes ◽  
Taylor Wilkerson ◽  
Jennifer Inker ◽  
Joann Richardson
Keyword(s):  
Older Adults ◽  
Behavior Change ◽  
Low Income ◽  
Self Efficacy ◽  
Large Scale ◽  
Health Coaching ◽  
Behavioral Risk ◽  
Racially Diverse ◽  
Individual Level

Abstract Preclinical Alzheimer’s disease (AD) behavioral risk reduction needs to be more fully explored at the community-level. Connecting behavior change to AD can reduce individual-level helplessness for the disease. However, behavior change targeting AD prevention factors (e.g., alcohol, depression, physical inactivity, smoking, isolation, medication management) is extremely challenging for multiple reasons, including failures in connecting AD and health behavior risk, and due to individual-level motivational, self-efficacy, and knowledge barriers. Methods: As part of the Virginia Commonwealth University iCubed Health and Wellness in Aging Population Core, 20 diverse older adults (aged 60+) living in Richmond, VA, with incomes below $12,000/year and managing either diabetes/cardiovascular symptoms, were offered weekly telephone-based health coaching for 12-weeks, providing education, motivations, self-efficacy skills, and referral services, for AD behavioral risk factors. A patient preference health coaching behavioral change strategy was implemented, where the person decides which behavioral practices to target. All study subjects completed a behavioral-psychosocial baseline and 3-month follow-up assessment. Findings: The study demonstrated feasibility for implementing health coaching within low-income racially-diverse older adults. The study sample (n=20, mean age 69 years (range: 61-77 years) was 90% African American (n=18), and 55% males (n=11). Improvement in AD knowledge (F=4.19;p=.0565); cognitive functioning (memory (F=4.19;p=.0556); delayed memory (F=2.85;p=.1086); TrailsA (F=5.60;p=.0294)), alcohol-risk (F=3.33;p=.1108) and social isolation (F=4.11;p=.0569) trends were found at 3-month follow-up. Conclusions: The findings from this study exhibit positive trends in reducing AD risk. This study creates the impetus for future large-scale investigations and dissemination of findings to improve the lives of at-risk low-income aging adults.

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