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Aim: To develop and pilot test an interactive mobile telehealth program (mHealth) for behavioral treatment of women veterans with urinary incontinence (UI). Methods: We developed an evidence-based 8-week behavioral mHealth program, MyHealtheBladder, with input from women veterans, behavioral medicine and health education experts, and clinical providers treating UI in the VA system. The program was story-based and included pelvic floor muscle exercises, bladder control strategies, fluid management, risk factor reduction, and self-monitoring. Participants were women veterans seeking outpatient treatment for UI occurring at least twice weekly. The primary efficacy estimate was the change in UI frequency, volume and impact on the quality of life as measured by the validated International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF; range: 0-21, 2.5 points for minimal clinically important difference [MCID]). Results:We enrolled 29 women veterans (ages 29-77 years; mean = 54.4 ± 10.4), including 15 (52%) African-American women, 13 (45%) women with high school education, and 16 (55%) with a college degree. Twenty of 29 women (69%) completed all 8 weeks of the intervention with a 97% adherence rate to the daily sessions among completers. We found reductions in ICIQ-SF scores from a mean 12.6 ± 3.9 at baseline to 10.4 ± 4.11 at 5 weeks, to 8.7 ± 4.0 at the end of the 8-week intervention. Conclusions: Women veterans using an 8-week behavioral mHealth program for the treatment of UI had symptom improvements that exceeded the MCID for the ICIQ-SF. Our next step involves comparing the effectiveness of MyHealtheBladder to usual care in a larger clinical trial. K E Y W O R D Sbehavioral therapy, mobile health, pilot study, telehealth, urinary incontinence, women veterans

Women in this sample were at high risk for unplanned pregnancies. Therefore, a primary contraceptive need for this population appeared to be education about longer lasting, user-independent forms of contraception. Many of these women would be ideal candidates for such forms of contraception, especially if it was provided prior to release.

Objectives This study examined differences in cessation success based on smokers' self-initiated pre-quit reductions in cigarettes per day (cpd). Methods The study utilized data from a nicotine replacement + behavioral therapy smoking cessation intervention conducted in a female prison facility with 179 participants who were wait-listed for 6 months prior to intervention. We compared two groups of smokers based on whether they self-selected to reduce smoking prior to their cessation attempt (n = 77) or whether they increased smoking or did not reduce (n= 102). General Estimating Equations (GEE) were used to model smoking cessation through 12-month follow-up. Results Examination of pre-cessation cpd showed that those who reduced were heavier smokers at baseline, relative to those who did not reduce (p < .001). By the week prior to the quit attempt (week 3) heavier smokers at baseline smoked significantly fewer cigarettes (p < .001) and had lower CO levels (p < .05) compared to baseline lighter smokers. GEE analyses showed that individuals who reduced prior to their quit attempt had significantly higher quit rates during early treatment but these gains were not sustained by follow-up points. Conclusions Participant-initiated pre-cessation smoking reduction may be initially helpful in preparing to quit smoking, or may serve as a marker for participant motivation to quit smoking, but these differences do not sustain over time. More intensive interventions are still needed for successful cessation.