Counselor and Stimulus Control Enhancements of a Stage-Matched Expert System Intervention for Smokers in a Managed Care Setting

Prochaska, James O.; Velicer, Wayne F.; Fava, Joseph L.; Ruggiero, Laurie; Laforge, Robert G.; Rossi, Joseph S.; Johnson, Sara S.; Lee, Patricia A.

doi:10.1006/pmed.2000.0767

Cited by 144 publications

(139 citation statements)

References 24 publications

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“…Across a growing range of population trials, the control groups attained abstinence rates of 16% to 19%, while the TTM Tailoring produced 22% to 26% abstinence at longer term follow-up (Prochaska et al, 1993(Prochaska et al, , 2001a(Prochaska et al, , 2001b(Prochaska et al, , 2004(Prochaska et al, , 2005. The abstinence rates with MI (34.6%) were higher than the 24% found with MI by Carpenter et al (2004), but that study limited their sample only to unmotivated smokers in the precontemplation or contemplation stages.…”

Section: Discussionmentioning

confidence: 96%

“…To date, the two most common trajectories with TTM tailoring have been either stable (e.g., with stress effects at six months remaining stable at 12 and 18 months, (Evers et al, 2006)) or increasing (e.g., with smoking cessation in the treatment group increasing over 18 months compared to the assessment only condition (Prochaska et al, 2001a(Prochaska et al, , 2001b(Prochaska et al, , 2004(Prochaska et al, , 2005.…”

Section: Limitationsmentioning

confidence: 99%

“…Finally, these results may lead some to conclude that more treatment is better, since both MI and TTM treatment groups had better 6 month outcomes than the HRI only condition. This concern is mitigated somewhat by studies that did not find a dose-response relationship for TTM tailored print interventions and by studies where more treatment was clearly not better (Prochaska et al, 2001b). Nevertheless, future studies should assess components of both MI and TTM-tailored treatments, including contact time.…”

Section: Limitationsmentioning

confidence: 99%

See 2 more Smart Citations

Initial efficacy of MI, TTM tailoring and HRI’s with multiple behaviors for employee health promotion

Prochaska¹,

Butterworth²,

Redding³

et al. 2008

Preventive Medicine

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210

197

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Objective-This study was designed to compare the initial efficacy of Motivational Interviewing (MI), Online Transtheoretical Model (TTM) Tailored communications and a brief Health Risk Intervention (HRI) on four health risk factors (inactivity, BMI, stress and smoking) in a worksite sample.Method-A randomized clinical trial assigned employees to one of three recruitment strategies and one of the three treatments. The treatment protocol included an HRI session for everyone and in addition either a recommended three TTM online sessions or three MI in person or telephone sessions over 6 months. At the initial post-treatment assessment at six months, groups were compared on the percentage who had progressed from at-risk to taking effective action on each of the four risks.Results-Compared to the HRI only group, the MI and TTM groups had significantly more participants in the Action stage for exercise and effective stress management and significantly fewer risk behaviors at 6 months. MI and TTM group outcomes were not different. Conclusion: This was the first study to demonstrate that MI and online TTM could produce significant multiple behavior changes. Future research will examine the long-term impacts of each treatment, their cost effectiveness, effects on productivity and quality of life, and process variables mediating outcomes. KeywordsMultiple behavior change; Motivational Interviewing; TTM Tailoring; exercise; stress; smoking; BMI Increasingly it is recognized that a major barrier to dissemination of evidence-based health promotion programs is that most programs were not designed or developed to reach at-risk populations (Glasgow et al., 2003). They were designed for and evaluated on self-selected samples of at-risk individuals. For example, in the United States Public Health Services Corresponding Author: James O. Prochaska, Ph.D., Cancer Prevention Research Center, 2 Chafee Road, University of Rhode Island, Kingston, RI 02881, Tel: 401-874-2830, Fax: 401-874-5562, jop@uri.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. 1996 Clinical Guidelines for the Treatment of Tobacco, over 3,000 studies on tobacco were identified. The Guidelines were able to recommend a broad range of evidence-based interventions for motivated smokers; i.e., those prepared to quit in the next month (Fiore et al., 1996). There were no evidence-based interventions recommended for unmotivated smokers, even though they make up more than 80% of all U.S. smokers (Velicer et al., 1995) and more than 90% of daily smokers (Wewers et al., 2003). In the second edition of the Guidelines there w...

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Section: Discussionmentioning

confidence: 96%

Section: Limitationsmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

See 1 more Smart Citation

Initial efficacy of MI, TTM tailoring and HRI’s with multiple behaviors for employee health promotion

Prochaska¹,

Butterworth²,

Redding³

et al. 2008

Preventive Medicine

Self Cite

210

197

View full text Add to dashboard Cite

show abstract

“…22 Promising results have been found for a small number of studies using telephone counseling to extend effects of a school-based prevention program, 30 to promote requitting among smokers with recent unsuccessful quit attempts, 31 to support short-term abstinence among low-income women provided with free nicotine patches and proactive calls, 32 to promote short-term abstinence among smokeless tobacco users, 33 and as part of a tailored intervention for African American smokers. 34 Mixed results have been found for proactive calls to augment personalized written feedback, with a 12-month effect found for calls when combined with stage-tailored materials and expert system personalized feedback in the second of 2 trials by Prochaska et al 35,36 and higher short-term abstinence reported in a trial by Curry et al 37 Mixed results have also been found for proactive calls to support nicotine replacement use. No effect was reported by earlier trials, 38 -40 although promising results have been found in a more recent trial by Solomon and colleagues 32 and in preliminary data from our trials.…”

Section: Evidence Base: Proactive Telecounselingmentioning

confidence: 99%

Quitlines in North America: Evidence Base and Applications

Ossip-Klein

McIntosh

2003

The American Journal of the Medical Sciences

143

101

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Quitlines provide a model for the translation of research findings to public health application. Quitlines are currently in operation in more than half of US states, in Canada, and in multiple countries globally. Overall, when implemented correctly, quitlines have been shown to be efficacious and effective. Multiple quitline models are in use, but there is no evidence on the relative effectiveness of one over the other. Differences have been demonstrated for the efficacy of quitlines for specific applications, with the strongest evidence base for application as a primary intervention or as follow-up for hospitalized patients and particularly for cardiac patients. The evidence base for both reactive and proactive services is reviewed, and future directions to continue to advance the field are discussed. Q uitlines provide an exemplary model of how research findings can be translated into public health application. The field began with a handful of researchers in the early 1980s and experienced marked growth through the past 2 decades. Currently, in North America, quitlines are in operation in more than 30 US states, a number of major American health systems, and multiple Canadian provinces. Quitlines are also available in multiple countries globally, including Denmark, France, Germany, Iceland, Ireland, Italy, Netherlands, Norway, Poland, Portugal, Spain, Sweden, Switzerland, the United Kingdom, Australia, New Zealand, and others.Overall, when implemented correctly, quitlines have been shown to be both efficacious and effective. The beneficial impact of quitlines has been supported by 3 meta-analyses 1-3 and by multiple individual studies.The purpose of this article is to provide an overview of the goals, range of services, and models for quitlines; to summarize the evidence base for what works; to discuss a special and growing application of quitlines to adolescents; and to provide a look at directions for the field. Overview: Goals, Range of Services, Quitline ModelsGoals. Quitlines can have the greatest potential impact when used as part of a comprehensive tobacco control effort. Within this context, quitlines can have 2 primary goals to maximize their public health influence. First, quitlines can provide direct service to help smokers quit. The Centers for Disease Control (CDC) estimates that only 2.5% of smokers quit permanently each year 4 ; similar figures have also been reported for the United Kingdom. 5 These rates suggest that there is considerable opportunity for quitlines to directly affect smoking cessation behavior; even a small percentage increase in quit rates has the potential to translate into meaningful public health change.A second primary goal of quitlines is to increase the number of smokers making a quit attempt each year, by awareness raising generated from promotional campaigns linked with quitlines. Even if success rates for quitting remain constant among those who try, increasing the number of smokers who make a quit attempt can yield a greater number of total quitters. About ...

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“…(45)). Several clinical trials have documented the ability of TTM interventions to recruit, retain, and effect change across a number of health behaviors including smoking (46,47), stress (48), depression prevention (49), and multiple health behaviors (50)(51)(52), and has also shown impacts on readiness to change, perceived treatment relevance, attendance at group treatment sessions, and attrition in Vietnam veterans with PTSD (53).…”

Section: Computerized Tailored Interventions (Ctis)mentioning

confidence: 99%

A computerized, tailored intervention to address behaviors associated with PTSD in veterans: rationale and design of STR2IVE

Jordan

Evers

Burke

et al. 2011

Behav. Med. Pract. Policy Res.

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Combat exposure among military personnel results in increased risk of posttraumatic stress disorder (PTSD), major depression, substance use, and related health risks. PTSD symptoms require innovative approaches to promote effective coping postdeployment. PTSD's nature and scope requires an approach capable of integrating multiple health risks while reaching large populations. This article provides the rationale and approach to adapt and evaluate a Pro-Change computerized tailored intervention (CTI) targeted at behavioral sequelae (i.e., smoking, stress, and depression) for veterans with or at risk for PTSD. The three-phase approach includes: 1) focus groups to review and, subsequently, adapt content of the existing CTI programs; 2) usability testing; and 3) feasibility testing using a three-month pre-postdesign. Effective, theory-based, real-time, multiple behavior interventions targeting veterans' readiness to quit smoking, manage stress, and depression are warranted to provide potential health impact, opportunities for learning veteran-specific issues, and advance multiple health behavior change knowledge.

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Counselor and Stimulus Control Enhancements of a Stage-Matched Expert System Intervention for Smokers in a Managed Care Setting

Cited by 144 publications

References 24 publications

Initial efficacy of MI, TTM tailoring and HRI’s with multiple behaviors for employee health promotion

Initial efficacy of MI, TTM tailoring and HRI’s with multiple behaviors for employee health promotion

Quitlines in North America: Evidence Base and Applications

A computerized, tailored intervention to address behaviors associated with PTSD in veterans: rationale and design of STR2IVE

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