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Impact of Intervention on Potential Mediating Cognitive Variables: Decisional Balance-Negative Consequences, Coping- Reinforcement, and Social Benefit
Source publication
Introduction:
Although web-based, multimedia smoking prevention programs have been tested in several high-income countries, their efficacy in Central and Eastern Europe is unknown. The aim of this trial was to assess the short-term effects of ASPIRA, among Romanian and Hungarian speaking ninth graders in Tirgu Mures, Romania. ASPIRA is the Romania...
Contexts in source publication
Context 1
... we analyzed the possible attrition bias during the follow-up separately in the two groups. The detailed analyses are presented in Supplementary Tables S2 and S3. Differences in lost to follow-up by treatment arm include: intervention arm par- ticipants lost to follow-up were more likely to be ever smokers (65.2% vs. 44.1%), ...
Context 2
... addition to the behavioral outcomes, we also tested the impact of the intervention on cognitive variables, namely the components of decision balance which might be important mediators of the treat- ment effect. The means, standard deviations, main and interaction effects are reported in Table 3. We detected a significant main effect only in negative consequences implying a decrease in the reported negative consequences of tobacco use over time. ...
Context 3
... we analyzed the possible attrition bias during the follow-up separately in the two groups. The detailed analyses are presented in Supplementary Tables S2 and S3. Differences in lost to follow-up by treatment arm include: intervention arm par- ticipants lost to follow-up were more likely to be ever smokers (65.2% vs. 44.1%), ...
Context 4
... addition to the behavioral outcomes, we also tested the impact of the intervention on cognitive variables, namely the components of decision balance which might be important mediators of the treat- ment effect. The means, standard deviations, main and interaction effects are reported in Table 3. We detected a significant main effect only in negative consequences implying a decrease in the reported negative consequences of tobacco use over time. ...
Similar publications
Background
Tobacco use is the second major cause of morbidity and the 4th most common health risk factor in the world. Medical professionals have a critical role in the process of smoking cessation both as advisers and behavioural models for the citizens. The aim of this study was to investigate the prevalence of smoking among health care professio...
Citations
... Parental consent and student approval were obtained prior to data collection. Detailed information about the questionnaire used within this research can be found in the study of Abram and co-authors [14,15]. The Ethics Commission of Scientific Research of the University of Targu Mures approved this research. ...
... In addition, previous research indicates that friends not only influence the susceptibility to tobacco use, but also the temptation to smoke, the young age to start smoking and the willingness to try new things in terms of tobacco use [26,27,28]. Recent studies suggest that although virtual friendships have become more common, teenagers who are subject to web-based interventions such as ASPIRE which aims to reduce their susceptibility and temptation to smoke give significant results, also should not be underestimated the importance of students' social interactions in smoking [15,29]. [30] suggested that parental smoking not only directly influences behavior; it also moderates their children's attitudes towards smoking and therefore influences their children's behavior. ...
... Egyik kutatási témánk keretében az amerikai szakemberek által kifejlesztett online dohányzásmegelőzési programot (ASPIRE) a helyi körülmények szerint adaptáltuk (ASPIRA), román és magyar nyelvre lefordítottuk, majd serdülők körében alkalmaztuk. Eredményeink kimutatták, hogy az ASPIRA számítógépes program jelentősen javítja a dohányzásra való rá nem szokást, így hasznos eszköz lehet az elsődleges megelőzésben [9]. Ennek érdekében kívánatos az ASPIRA online prevenciós program ismertetése és esetleges kiterjesztése. ...
Between 2012–2018 the University of Medicine and Pharmacy from Tirgu Mureș in partnership with American, Hungarian and Romanian scientists from dozen institutions have launched a research entitled Building Capacity for Tobacco Research in Romania composed of seven complementary research studies. In our paper there are highlighted some timely and specific issues inside the research such as the possibility of computer-based online school prevention, smoking habits of residents and employees of social children’s institutions, the adaptation of a proper legislation and tobacco control, right to clean and smoking-free air. It remains very important the support for tobacco smoke-free, the maintenance of anti-smoking campaigns, the extension of prevention to the juvenile population in order to reduce smoking and the use of alternative tobacco products.
... In this study, we provide optional combined cessation interventions based on smokers' smoking status and preference. These interventions, including multimedia message [17,18], nicotine replacement therapy sampling [19], active referral plus financial incentive [20], phone counselling [21], and social support [22], are evidence-based and supported by our previous trials. This study protocol describes the design and rationales of an adaptive trial that aims to evaluate the effectiveness of personalised mHealth intervention on quitting among community-recruited smokers. ...
Background
Mobile health (mHealth) is promising in developing personalised smoking cessation interventions. By using an adaptive trial design, we aim to evaluate the effectiveness of personalised mHealth intervention in increasing smoking cessation.
Methods
This study is a two-arm, parallel, accessor-blinded Sequential Multiple-Assignment Randomised Trial (SMART) that randomises 1200 daily cigarette smokers from 70 community sites at two timepoints. In the first phase, participants receive brief cessation advice plus referral assistance to smoking cessation services and are randomly allocated to receive personalised instant messaging (PIM) or regular instant messaging (RIM). In the second phase, PIM participants who are non-responders (i.e. still smoking at 1 month) are randomised to receive either optional combined interventions (multi-media messages, nicotine replacement therapy sampling, financial incentive for active referral, phone counselling, and family/peer support group chat) or continued-PIM. Non-responders in the RIM group are randomised to receive PIM or continued-RIM. Participants who self-report quitting smoking for 7 days or longer at 1 month (responders) in both groups continue to receive the intervention assigned in phase 1. The primary outcomes are biochemical abstinence validated by exhaled carbon monoxide (< 4 ppm) and salivary cotinine (< 10 ng/ml) at 3 and 6 months from treatment initiation. Intention-to-treat analysis will be adopted.
Discussion
This is the first study using a SMART design to evaluate the effect of adaptive mHealth intervention on abstinence in community-recruited daily smokers. If found effective, the proposed intervention will inform the development of adaptive smoking cessation treatment and benefits smokers non-responding to low-intensity mHealth support.
Trial registration
ClinicalTrials.gov NCT03992742 . Registered on 20 June 2019.
... This health education curriculum should be taught by teachers or trained professionals using role play, debates, construction practices for simulations about smoking, studies on the components of tobacco, the effects of tobacco on the body, and diseases caused, learning through the experience of people with laryngeal or lung cancer with a history of smoking. 35 Moreover, behavioural change interventions which seeks to explore social influence, environmental context, belief in abilities and emotional levels as well as peer education are also incorporated into the school based programs. This approach stems from the idea that peers have greater credibility among young people, have the same cultural background, and have greater understanding and empathy. ...
Background:
Due to the health consequences and economic losses associated with tobacco, the WHO Framework Convention on Tobacco Control, a worldwide effort to control the effects of tobacco smoking on human health enacted a set of policies to curb tobacco use. Smoking cessation services aim to ensure that every patient is screened for tobacco use, their tobacco use status is documented, and patients who use tobacco are advised to quit. Dental health professionals are strategically positioned to reach many tobacco users and this proposal provides a simple framework whereby dentistry could play a major role in smoking cessation efforts.
Interventions:
Strategies for incorporating Cessation Services into Oral Health Care Delivery include the School Oral Health programs through Public Health Dentistry, updating the Dental School Curriculum through dental education regarding tobacco use prevention and cessation; including Tobacco Treatment Specialists certification in Postgraduate Curriculum for Dental Public Health; Continuing Medical Education (CME) focused on cessation services for dental personnel; Clinical Smoking Cessation Interventions in Dental settings; Compensation of Dental personnel for tobacco use prevention and cessation services; and ongoing research, evaluation and monitoring.
Conclusion:
Incorporation of these evidence-based treatments into dental practice would result in more individuals achieving long-term abstinence and thus reduce tobacco-related death, disease, and economic loss worldwide.
... Our colleagues from Romania have successfully replicated the impact of ASPIRE in a randomized controlled trial among local youth. 13 Authors decided to conduct a preliminary study of the new version of ASPIRE in India. ...
... 10,18 Although ASPIRE is in the process of being tested in Western countries, it is also tested by some low-to middle-income countries and found effective and efficient tool reducing smoking initiation in youth. 13 Results of present preliminary study are consistent with the reports of ASPIRE impact elsewhere. ...
Online education approach provides innovative opportunities for engaging youths. Web-based, multimedia smoking prevention programs have been tested in high-income countries; however, efficacy of such programs is not well-investigated in low- and middle-income countries. The aim of this study was to evaluate the impact of A Smoking Prevention Interactive Experience (ASPIRE), an interactive tobacco prevention curriculum, among university students in India.
A single-subject cohort study where each subject serves as their own control was conducted among university student participants engaged in ASPIRE, 60 minutes per week for five consecutive weeks during July to August of 2019. Assessments were conducted at baseline and immediately after exposure to ASPIRE. To evaluate the program, a structured instrument was specifically designed to measure the outcomes.
A total of 103 university students participated voluntarily. Average age of the participants was 18.3±0.9 ranging from 17 to 20 years. Eighteen percent of students were curious to know about the various smoking products. More males were more susceptible to cigarette smoking as compared to females. The majority of participants felt that ASPIRE was culturally appropriate for young adults in India, but a modified version targeted toward Indian youth would be more acceptable. Pre- to postintervention knowledge of tobacco-related hazards increased from 70 to 97% (p < 0.001).
ASPIRE, a multimedia interactive program, demonstrated its considerable potential to discourage smoking initiation among Indian youth.
... is different among cities in Europe. The average prevalence rate of daily smoking was: 26.8% in Latina (Italy), 24.5% in Namur (Belgium), 16.8% in Tampere (Finland), 12.2% in Hannover (Germany), 12.4% in Amersfoort (Netherlands), and 19.7% in Coimbra (Portugal) 8 . Other studies also demonstrated that the socioeconomic status of school and family influence the smoking behavior of adolescents. ...
... The prevalence of tobacco consumption in Romania among the ninth-grade students was estimated at 48.4% for those who have tried to smoke at least once, and 21.4% for those who were current smokers 16 . Among resident children from foster-care homes in four Transylvanian counties, 44.6% had tried to smoke cigarettes at least once and about one in four (25.9%) reported that they smoked cigarettes in the past 30 days 17 . ...
INTRODUCTION: The aim of this study was to evaluate the potential impact of the
changes in the national legislation on tobacco consumption and the impact of the
implementation of the National Tobacco Control Program on ninth-grade students
in Chisinau, Moldova, during 2015 and 2018, as well as tobacco consumption
behavior and exposure to pro- and anti-tobacco messages.
METHODS: The study sample consisted of the ninth-grade students from 132 schools
in Chisinau, Moldova. It included 20 randomly selected schools (3 gymnasiums
and 17 high schools). Data were collected using a validated self-completed
questionnaire, once in October–December 2015 (n=368) and repeated in
February–April 2018 (n=819). The chi-squared test was applied to compare
categorical variables between the 2015 and 2018 groups.
RESULTS: The student participants had mean age of 14.8 ± 0.49 years (2015) and
14.9 ± 0.53 years (2018), and, by coincidence, both groups had 51.9% boys
and 48.1% girls. However, despite the rather strict regulations on tobacco in
Moldova, adolescents still report a significant increase in the prevalence of
cigarette consumption in the last 30 days in the period from 2015 to 2018. In this
period, anti-smoking messages increased significantly and were seen by students
in shopping malls, supermarkets (35.1% in 2015 and 60.0% in 2018), cinemas
(11.7% in 2015 and 36.5% in 2018), magazines and newspapers (19.3% in 2015
and 37.6% in 2018) (p<0.001).
CONCLUSIONS: Tobacco consumption among ninth-grade pupils had increased
between 2015 and 2018 in Chisinau, Moldova. Adolescents represent a critical
subpopulation of smokers and tobacco control experts must concentrate their
efforts to reduce their exposure to pro-smoking messages and increase their
exposure to anti-smoking messages (via internet, sport events, etc.).
... 63 Ayrıca, orijinal olarak ABD'de geliştirilmiş ve Avrupa'da uygulanan diğerlerinden farklı olarak Web temelli uygulanan bir önleme programının da programa erişim yüzdesiyle doğru orantılı olarak sigaraya başlamayı azalttığı görülmüştür. 64 TÜTÜN KuLLANIMINDA İKİNcİL ÖNLEME Birçok müdahale kişilerin sigarayı bırakmasına yardım edebilmektedir. Bunların içerisinde nikotin yerine koyma tedavisi, antidepresanlar (bupropion vb.) ve nikotin reseptör parsiyel agonistleri (vareniklin vb.) gibi farmakolojik tedaviler ve bireysel ve grup halinde uygulanabilen davranışsal müdahaleler yer almaktadır. ...
ABSTRACT
Studies on tobacco use, which is the leading cause for preventable death, show that tobacco use is a risk factor for several diseases including many types of cancer. Within this context, apart from tobacco use prevention work in general, course and treatment of tobacco use in cancer population is important. In this study, association between cancer treatment and tobacco use/ treatment, socio-demographic variables determining treatment success in cancer patients, primary and secondary prevention work in tobacco use, traditional tobacco use methods such as hookah, which is found to be largely affected by cultural factors, as well as new generation tobacco products such as heat-not- burn tobacco products and electronic cigarettes have been discussed.
ÖZET
Önlenebilir ölüm nedenlerinin başında gelen tütün kullanımı ile ilgili bilimsel çalışmalar, tütün kullanımının farklı kanser türleri dahil olmak üzere birçok hastalık için risk faktörü olduğunu göstermektedir.
Bu bağlamda tütün kullanımının genel anlamda önlenmesine yönelik çalışmalarla birlikte, tütün kullanımının kanser popülasyonunda seyri ve tedavisi önem arz etmektedir. Bu çalışmada, kanser hastalığı
ve tedavisi ile tütün kullanımı ve sonlandırılması arasındaki ilişki, kanser hastalarında tedavi başarısını belirleyen sosyo-demografik değişkenler, tütün kullanımına yönelik birincil ve ikincil önleme
çalışmaları, nargile vb. kültürel faktörlerin belirleyici olduğu görülen geleneksel tütün kullanım yöntemlerinin yanı sıra, elektronik sigara ve ısıtmalı tütün ürünleri vb. yeni nesil tütün ürünleri tartışılmıştır.
... Unfortunately, in Romania, the balance remains inclined in favor of the pro-smoking advertisement (7). As this is the one that predisposes to smoking, there is a need for a law containing stipulations regarding the prevention and control of tobacco consumption. ...
Aim of the study: the aim was to identify the knowledge and practices related to active smoking among dental students. Material and methods: The study involved the questionnaire-based survey. Results: The impact of some media is interesting: 65.6% of the total respondents stated that in the last year they have heard or seen shows about the negative effects of tobacco consumption. Conclusions: The interviewees stated that in the last year they have heard or seen shows about the negative effects of tobacco use.
... 7,8 Additional noteworthy indicators of ASPIRE effectiveness are the favorably reviews by Cochrane 9 and the National Cancer Institute (NCI), leading to ASPIRE been placed in the database of NCI Research-Tested Intervention Programs. 10 While findings are promising for web-based behavioral interventions for smoking prevention among school-age children in the United States (US) and other developed nations, 11-18 similar innovative and effective interventions are nonexistent for Spanish-speaking children and adolescents in the Latin American region, an important public health gap. Although the ASPIRE program has a Spanish version, it was developed for Hispanic/Latino children and adolescents living in the US and thus used a Spanish dialect with anglicisms that are not well understood across Latin America. ...
Objective:
Development of a linguistically advanced and culturally appropriate Spanish version of ASPIRE (A Smoking Prevention Interactive Experience) and its evaluation among school-age children from Colombia and Mexico was performed.
Material and methods:
The current study sought to employ a structured adaptation approach in the development of an improved Spanish version of ASPIRE, which is an online, interactive multimedia program designed for middle and high school students that has shown success in decreasing smoking initiation.
Results:
For the overall sample, the mean value for the pretest knowledge score before accessing ASPIRE was 62.5 (± 10.33), while the mean value for the post-test score after completing the multimedia program was 77.5 (± 15.42).
Conclusions:
Following edits and changes to the Spanish script based on expert comments we were able to further elaborate culturally appropriate content during the youth focus groups. This «bottom-up» approach provided meaningful input from the targeted adolescents themselves.
... Low dosage was considered from 0% to 66.6%, whereas high dosage was considered from 66.7% to 100%, but the reasons for choosing the cut-off value are not provided. 13 In a previously published study, Nădăşan et al 14 have shown that students exposed to 75% or more of a web-based smoking prevention curriculum were significantly less likely to initiate smoking than those in the control group, suggesting that increasing the level of participants' exposure may maximize the impact of the intervention. In this study, high program exposure was defined as being exposed to 75% to 100% of the educational content based on the judgment of the experts involved in the research, considering the actual content of the educational curriculum. ...
... In this study, high program exposure was defined as being exposed to 75% to 100% of the educational content based on the judgment of the experts involved in the research, considering the actual content of the educational curriculum. 14 The aim of the study was to identify the predictors of high program exposure among a group of adolescents participating in the ASPIRE smoking prevention intervention in Târgu Mureş, Romania. ...
... The detailed description of the variables is available in previously published work. 14 The baseline assessment was performed in November to December 2014 and the follow-up assessment in May 2015. Participation in the study was voluntary and the enrollment started following the approval by the Institutional Review Board of The University of Medicine, Pharmacy, Sciences, and Technology of Târgu Mureș, and the participants' parental written consent. ...
Introduction
Web-based smoking prevention programs can be delivered to large groups of adolescents under relatively private conditions at a convenient cost, but their effectiveness is highly dependent on the level of exposure to the educational content. The objective of the study was to identify the predictors of high program exposure among a group of adolescents participating in a web-based smoking prevention cluster randomized trial in Romania.
Methods
The study sample included 675 adolescents from Târgu Mureş, Romania. The level of exposure to the ASPIRE web-based smoking prevention program was monitored using data automatically saved on the system server. High program exposure was defined as watching 75% to 100% of the educational content. Associations between adolescents’ sociodemographic, psychological, and behavioral variables collected online at the beginning of the intervention and high program exposure were tested using chi-square test and logistic regression.
Results
In all, 68.3% of students were highly exposed to the program. There were 4 significant predictors of high program exposure in the multivariable logistic regression model: participant’s father’s lower level of education (odds ratio [OR]: 1.75; 95% confidence interval [CI]: 1.19-2.44), participant’s brother’s nonsmoking status (OR: 1.76; 95% CI: 1.13-2.72), never trying e-cigarettes (OR: 1.73; 95% CI: 1.22-2.45), and considering the health of others an important reason not to smoke (OR: 2.46; 95% CI: 1.54-3.93).
Conclusions
The analysis identified sociodemographic, psychological, and behavioral factors that may be useful in project management of such intervention to improve program effectiveness.
