A brief intervention to increase the dialogue between patients and health care providers about behavioral goals can lead to increased physical activity and weight loss.

Introduction: Pharmacists are uniquely positioned within the community to provide smoking cessation counseling to their patients. However, pharmacists experience significant barriers to providing counseling, including limited time, reimbursement, and training in counseling techniques. We tested a computer-driven software system, "Exper_Quit" (EQ), that provided individually tailored interventions to patients who smoke and matching tailored reports for pharmacists to help guide cessation counseling. Methods:A two-phase design was used to recruit an observationonly group (OBS; n = 100), followed by participants (n = 200) randomly assigned to receive either EQ-assisted pharmacist counseling or EQ plus 8 weeks of nicotine transdermal patch (EQ+). Both treatment groups were scheduled to receive two follow-up counseling calls from pharmacists.Results: Most participants in the EQ and EQ+ groups reported receiving counseling from a pharmacist, including follow-up calls, while none of the OBS participants reported speaking with the pharmacist about cessation. At 6 months, fewer OBS participants reported a quit attempt (42%) compared with EQ (76%) or EQ+ (65%) participants (p < .02). At 6 months, 7-day point-prevalence abstinence was 28% and 15% among the EQ+ and EQ groups, respectively, compared with 8% among OBS participants (p < .01), and EQ+ participants were twice as likely to be quit than were EQ participants (p < .01).Discussion: A tailored software system can facilitate the delivery of smoking cessation counseling to pharmacy patients. Results suggest that EQ was successful in increasing (a) the delivery of cessation counseling, (b) quit attempts, and (c) quit rates. Pharmacists can play an important role in the effective delivery of smoking cessation counseling.

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The direct and generalized effects of a parent-administered, positive reinforcement and physical restraint procedure upon the inappropriate behavior of an institutionalized, severely retarded boy were examined. The boy's mother was trained to administer the training package contingent upon three of her son's responses during a play situation conducted within the institutional setting. A hybrid of multiple baseline and reversal designs was employed to assess the effects of the procedures on the child's target behaviors. Results indicate that the procedures were effective in directly increasing the child's instruction-following behavior and decreasing his noncompliance and inappropriate play responses. Moreover, a correlated reduction in the boy's untreated aggression and clothes stripping was observed. Follow-ups conducted over a 4-month period indicate that all treatment effects were maintained over time. Possible explanations for why treatment produced a generalized decrease in responding are discussed.