The implementation of cigarette smoking abstinence reinforcement programs may be hindered by the time intensive burden placed on patients and treatment providers. The use of remote monitoring and reinforcement of smoking abstinence may enhance the accessibility and acceptability of this intervention, particularly in rural areas where transportation can be unreliable and treatment providers distant. This study determined the effectiveness of an Internet-based abstinence reinforcement intervention in initiating and maintaining smoking abstinence in rural smokers. Sixty-eight smokers were enrolled to evaluate the efficacy of an Internet-based smoking cessation program. During the 6-week intervention period, all participants were asked to record 2 videos of breath carbon monoxide (CO) samples daily. Participants also typed the value of their CO readings into web-based software that provided feedback and reinforcement based on their smoking status. Participants (n=35) in the Abstinence Contingent (AC) group received monetary incentives contingent on recent smoking abstinence (i.e., CO of 4 parts per million or below). Participants (n=33) in the Yoked Control (YC) group received monetary incentives independent of smoking status. Participants in the AC group were significantly more likely than the YC group to post negative CO samples on the study website (OR = 4.56; 95% CI = 2.18–9.52). Participants assigned to AC were also significantly more likely to achieve some level of continuous abstinence over the 6-week intervention compared to those assigned to YC. These results demonstrate the feasibility and short-term efficacy of delivering reinforcement for smoking abstinence over the Internet to rural populations.

Completion of the Human Papillomavirus (HPV) vaccine series is a national priority. This study not only identified correlates of intent to complete the vaccine series and actual series completion, but also tested the efficacy of a DVD intervention to promote series completion. Women's beliefs that all three doses reduced cancer risk predicted intent and completion. Intention predicted completion, as did the belief that having a friend accompany the woman would promote completion. Beyond these effects, women assigned to the intervention were 2.44 times more likely than women in the control group to complete the series. Thus, in controlled analyses, a theory-grounded DVD intervention successfully promoted HPV series completion in a community setting. This method of intervention has high translational potential.

Initial uptake of free HPV vaccination among young rural college women may be problematic. Moreover, uptake of subsequent free doses among rural women may be problematic regardless of whether contact is made in a clinic or through college recruitment.

Purpose-This study aimed to: (a) describe the Strength of Tobacco Control (SoTC) capacity, efforts and resources in rural communities, and (b) examine the relationships between SoTC scores and sociodemographic, political and health-ranking variables.Methods-Data were collected during the baseline pre-intervention phase of a community-based randomized, controlled trial. Rural counties were selected using stratified random sampling (n = 39). Key informant interviews were employed. The SoTC, originally developed and tested with states, was adapted to a county-level measure assessing capacity, efforts, and resources. Univariate analysis and bivariate correlations assessed the SoTC total score and construct scores, as well as their relationships. Multiple regression examined the relationships of county-level sociodemographic, political and health-ranking variables with SoTC total and construct scores.Findings-County population size was positively correlated with capacity (r = 0.44; P < .01), efforts (r = 0.54; P = .01) and SoTC total score (r = 0.51; P < .01). Communities with more resources for tobacco control had better overall county health rankings (r = .43; P < .01). With population size, percent Caucasian, tobacco production, and smoking prevalence as potential predictors of SoTC total score, only population size was significant.Conclusions-SoTC scores may be useful in determining local tobacco control efforts and appropriate planning for additional public health interventions and resources. Larger rural communities were more likely to have strong tobacco control programs than smaller communities. Smaller rural communities may need to be targeted for training and technical assistance. Leadership development and allocation of resources are needed in all rural communities to address disparities in tobacco use and tobacco control policies. in urban areas.1 , 3 -5 Furthermore, those living in rural communities are more likely to be exposed to secondhand smoke than those living in urban areas.6 KeywordsDespite the fact that smoke-free and other tobacco control laws are gaining popularity in the United States and globally, rural communities have fewer smoke-free laws and voluntary restrictions than do their urban counterparts.6 , 7 Further, smaller towns are less likely than larger ones to enact smoke-free policies.8 , 9 As efforts to enact smoke-free laws and other tobacco control policies increase, assessing local efforts, capacity and resources for tobacco control grows more important, especially in rural, underserved communities that may be late in adopting these laws.Mobilizing local communities to enact tobacco control policies is recommended in the Centers for Disease Control and Prevention's (CDC) community-based model for tobacco control.10 The premise of the model, currently implemented in several states, is to promote policy development at both local and state levels to change social norms related to tobacco control.The Strength of Tobacco Control (SoTC) instrument was initially developed to evalua...

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