AIM-To develop and validate a measure of smokers' expectancies for the abstinence process upon quitting smoking: the Smoking Abstinence Questionnaire (SAQ).DESIGN-Principal component analysis and other psychometric analyses of self-report data. SETTING-San Francisco, California.PARTICIPANTS-507 adult smokers of at least 10 cigarettes per day diverse in gender, sexual orientation, and ethnoracial status. Gain. The SAQ factors demonstrated internal consistencies ranging from .62 to .85 and were associated with tobacco dependence, motivation to quit, abstinence self-efficacy, withdrawal symptoms, dietary restraint, shape and weight concern, and tobacco use expectancies. The SAQ predicted smoking-related constructs above and beyond tobacco use expectancies, suggesting that abstinence-related expectancies and tobacco use expectancies are distinct from one another. MEASUREMENTS-TheCONCLUSIONS-A newly developed questionnaire, the SAQ, appears to reliably capture smokers' expectancies for abstinence (Withdrawal, Social Improvement/Nonsmoker Identity, Adverse Outcomes, Common Reasons, Optimistic Outcomes, Coffee Use, and Weight Gain) and expectancies related to the success of a quit attempt (Treatment Effectiveness, Barriers to Treatment, and Social Support). It remains to be seen how far any of these expectancies predict attempts to quit, withdrawal, treatment utilization and response, and quitting success above and beyond existing measures.

Research has documented tobacco-related health disparities by race and gender. Prior research, however, has not examined expectancies about the smoking cessation process (i.e., abstinence-related expectancies) as potential contributors to tobacco-related disparities in special populations. This cross-sectional study compared abstinence-related expectancies between American Indian (n = 87), African American (n = 151), and White (n = 185) smokers, and between women (n = 231) and men (n = 270) smokers. Abstinence-related expectancies also were examined as mediators of race and gender relationships with motivation to quit and abstinence self-efficacy. Results indicated that American Indians and African Americans were less likely than Whites to expect withdrawal effects, and more likely to expect that quitting would be unproblematic. African Americans also were less likely than Whites to expect smoking cessation interventions to be effective. Compared to men, women were more likely to expect withdrawal effects and weight gain.These expectancy differences mediated race and gender relationships with motivation to quit and abstinence self-efficacy. Findings emphasize potential mechanisms underlying tobacco-related health disparities among American Indians, African Americans, and women, and suggest a number of specific approaches for targeting tobacco dependence interventions to these populations.

IMPORTANCE Research has shown that higher activation and engagement with health care is associated with better self-management. To our knowledge, the linkage intervention (LINKAGE) is the first to engage patients receiving addiction treatment with health care using the electronic health record and a patient activation approach. OBJECTIVE To examine the effects of an intervention aiming to link patients receiving addiction treatment with health care. DESIGN, SETTING, AND PARTICIPANTS A nonrandomized clinical trial evaluating the LINKAGE intervention vs usual care by applying an alternating 3-month off-and-on design over 30 months. Participants were recruited from an outpatient addiction treatment clinic in a large health system between April 7, 2011, and October 2, 2013. INTERVENTIONS Six group-based, manual-guided sessions on patient engagement in health care and the use of health information technology resources in the electronic health record, as well as facilitated communication with physicians, vs usual care. MAIN OUTCOMES AND MEASURES Primary outcomes, measured at 6 months after enrollment, were patient activation (by interview using the Patient Activation Measure), patient engagement in health care (by interview and electronic health record), and alcohol, drug, and depression outcomes (by interview using the Addiction Severity Index for alcohol and drug outcomes and Patient Health Questionnaire (PHQ) for depression). RESULTS A total of 503 patients were recruited and assigned to the LINKAGE (n = 252) or usual care (n = 251) conditions, with no differences in baseline characteristics between conditions. The mean (SD) age of the patients was 42.5 (11.8) years, 31.0% (n = 156) were female, and 455 (90.5%) completed the 6-month interview. Compared with usual care participants, LINKAGE participants showed an increase in the mean number of log-in days (incidence rate ratio, 1.53; 95% CI, 1.19–1.97; P = .001). Similar results were found across types of patient portal use (communicating by email, viewing laboratory test results and information, and obtaining medical advice). LINKAGE participants were more likely to talk with their physicians about addiction problems (odds ratio, 2.30; 95% CI, 1.52–3.49; P < .001). Although 6-month abstinence rates were high for both conditions (≥70.0% for both) and depression symptoms improved (the proportion with scores≥15 on the 9-item PHQ dropped from 15.1% [38 of 252] to 8.0% [18 of 225] among LINKAGE participants), there were no differences between conditions. Those who received all intervention components had significantly better alcohol and other drug outcomes than those who received fewer intervention components. CONCLUSIONS AND RELEVANCE Findings support the feasibility and effectiveness of the LINKAGE intervention in helping patients receiving addiction treatment engage in health care and increase communication with their physicians. The intervention did not affect short-term abstinence or depression outcomes. Understanding if the LINKAGE intervention helps ...

Smokers' expectancies regarding the effects of cigarette use are powerful predictors of smoking motivation and behavior. However, studies have not investigated the consequences that smokers expect when they attempt to quit smoking: abstinence-related expectancies. The primary goal of this qualitative study was to gain initial insight into smokers' expectancies for abstinence. Eight focus groups were conducted with 30 smokers diverse with respect to age, gender, and ethnoracial background. Content analyses indicated that smokers anticipate a variety of outcomes from abstinence. The most frequently reported expectancies included pharmacologic withdrawal symptoms, behavioral withdrawal symptoms, decreased monetary expense, and immediate improvement of certain aspects of physical functioning and health. Additional expectancies concerned weight gain, improved attractiveness, enhanced social functioning/self-esteem, long-term health outcomes, and loss of relationships. Finally, a number of relatively unheralded expectancies were revealed. These involved NRT effectiveness, alcohol and other drug use, vigilance to cue reactivity, cessation-related social support, aversion to smoking, and "political process" implications. This study provides a preliminary step in understanding smokers' expectancies for abstinence from cigarettes. Keywordstobacco; smoking; abstinence; cessation; expectancies Smoking-related outcome expectancies remain among the most widely-examined constructs in studies of tobacco use (e.g., Hendricks & Brandon, 2008;Kirchner & Sayette, 2007). They predict the onset and trajectory of smoking (e.g., Cohen, McCarthy, Brown, & Myers, 2002;Wetter et al., 2004), are associated with current smoking behavior (e.g., Cepeda-Benito & Ferrer, 2000;Jeffries et al., 2004), predict the magnitude of smoking withdrawal symptoms (Wetter et al., 1994), and predict both short-and long-term treatment outcome (e.g., Wahl, Turner, Mermelstein, & Flay, 2005;Gwaltney, Shiffman, Balabanis, & Paty, 2005 NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptDespite the research focus on smoking-related outcome expectancies, no prior study has directly examined smokers' expectancies for abstinence. That is, no previous investigations have directly explored the effects that smokers anticipate when they attempt to cease cigarette use. Several studies have appraised smokers' reasons for quitting. The most commonly offered motives for cessation comprise concerns about the effects of smoking on physical functioning and health, including the effects of secondhand tobacco smoke on others; the financial disincentive of cigarette use; pressure to quit from family, friends, and society at large; and the desire to improve one's appearance and self-esteem (e.g., Hyland et al., 2004;Myers & MacPherson, 2008;West, McEwen, Bolling, & Owen, 2001). Additional research has assessed smokers' perceived barriers to successful cessation. Frequently noted barriers include pharmacologic and behavioral withdrawal symptoms, includ...

The purpose of the current systematic review was to examine the effects of music interventions on cognitive function in older adults with mild cognitive impairment (MCI). A systematic search of CINAHL, PubMed, PsycINFO, and Web of Science databases was performed. Studies examining the effects of music interventions on cognitive function in older adults with MCI were included. Narrative synthesis for cognitive outcomes postintervention was performed. A total of 11 articles met inclusion criteria. Music interventions significantly improved global cognitive function, verbal fluency, executive function, and spatial function in older adults with MCI. Included studies were heterogeneous in terms of the type of intervention, cognitive assessment tool, and intervention duration. Six studies were at risk of bias due to missing data and confounding factors. Our findings suggest that music interventions can be an effective strategy to improve cognitive function for older adults with MCI. However, findings should be interpreted with caution. More rigorous studies with various types of music interventions investigating cognitive domain–specific effects are needed. [ Research in Gerontological Nursing, xx (x), xx–xx.]