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Biomedical subjects

J A Best

Publications and source records attributed to J A Best.

At least 37 records · Page 2Linked to original sources
PubMed1989

Tracking and attrition in longitudinal school-based smoking prevention research.

Research in the development of school-based smoking prevention programs has resulted in a set of approaches of known short-term efficacy. Further evaluation of these approaches now requires long-term follow-up of participants. To minimize the problems caused by attrition in these longitudinal studies, investigators have developed techniques for tracking study participants. Based primarily on the use of the telephone, mail, and public documents, these methods require good background information on both the study participants and their parents. This article summarizes the experience of three teams of researchers engaged in such follow-up studies. These investigators have identified the types of background information most useful in long-term follow-up of participants, have developed a set of strategies to obtain such background information, and have developed methods for successfully tracking participants after a lapse of several years.

Adolescent↗
PubMed1989

Six-year follow-up of the first Waterloo school smoking prevention trial.

This paper reports six-year follow-up data from the first large-scale randomized trial of the social influences approach to smoking prevention. In 1979, 22 schools were randomly assigned to program or control conditions. Students in program schools received a social influences curriculum in six core and two maintenance sessions in grade 6, two booster sessions in grade 7, and one booster session in grade 8. All students were assessed at pretest (T1), immediate posttest (T2), end of grade 6 (T3), beginning and end of grade 7 (T4 and T5), end of grade 8 (T6), and grades 11 and 12 (T7 and T8). Ninety percent of study students were relocated and data obtained from over 80 percent of them at T8. Program effects on experimental smoking observed in grades 7 and 8 had completely decayed by T8, six years after the beginning of the program. Grade 6 smoking experience and social risk were each strong predictors of T8 smoking behavior. Subjects who had left school were smoking at more than twice the rate of subjects still in high school (grade 12) at T8. We discuss implications of the results.

Adolescent↗
PubMed1989

Smoking cessation in primary care. A randomized controlled trial of nicotine-bearing chewing gum.

The results are reported from a multicentered, randomized clinical trial of a physician-delivered smoking cessation intervention package. All physicians attended a four-hour training session during which the rationales for the different aspects of the intervention were discussed, including a detailed description of the proper use of nicotine-bearing chewing gum. Patients were randomized to receive an offer of a prescription of 2 mg of nicotine chewing gum in addition to the basic intervention (n = 111) or the basic intervention alone (n = 112). The basic intervention included advice, setting a date for quitting, self-help materials, and the offer of supportive follow-up visits. Receptionists were instructed to recruit the first two smokers attending the practice each day. One-year smoking cessation was validated by cotinine saliva analysis. The validated three-month sustained abstinence rates at one year were 8.1 percent and 9.8 percent in the gum and no-gum groups, respectively. The 95 percent confidence interval about this difference was -9.3 percent to 6.4 percent. There is no evidence from this study that the offer of 2 mg of nicotine-bearing gum enhances smoking cessation rates when added to a comprehensive intervention offered to all smokers in primary care. Until larger trials are completed, however, the possibility that this dose of nicotine gum may produce small beneficial effects cannot be excluded.

Chewing Gum↗
PubMed1988

A randomized trial of a family physician intervention for smoking cessation.

We assessed the impact of three conditions on one-year smoking cessation rates. Physicians in 70 community general practices were randomly allocated by practice to one of three groups: In the usual care group, smoking patients were to receive the care they normally would receive. In the gum only group, physicians were asked to speak to patients about smoking cessation and offer nicotine gum. In the gum plus group, physicians were trained in the experimental intervention. This intervention involved advice to stop smoking, the setting of a quit date, the offer of nicotine gum, and four follow-up visits. Smoking cessation was measured by self-report after one year and validated using saliva cotinine measures. Using a criterion of at least three months of abstinence, 8.8% of the patients of the trained physicians had stopped smoking at the one-year follow-up compared with 4.4% and 6.1% of the patients in the usual care and gum only groups, respectively.

Adolescent↗
PubMed1988

Preventing cigarette smoking among school children.

Research to develop and ensure diffusion of smoking prevention programs must (a) be based on an appreciation of the social, psychological, and biological determinants at each stage in the onset process, (b) disentangle major interactions between program content, participant, provider, and setting factors as they determine impact, and (c) ensure both that diffusion is based on empirically grounded principles and that the process is monitored and its effectiveness evaluated. Sufficient evidence supports the tentative conclusion that social influence curricula can be efficacious--at least with some youth. However, we lack key information for diffusion, in particular concerning provider and setting factors. Thus, a cautious advance to diffusion research is recommended, noting that there is much we do not know, and that the public health need for applications must be balanced with continuing research to clarify for whom and under what circumstances current curricula work. At the same time, there should be strong continuing research to improve current interventions, especially for high risk populations.

Adolescent↗
PubMed1987

Supportive follow-up for cigarette smokers in a family practice: issues of method, analysis and state of the art.

Kozlowski and Page have criticized a study published in 1982 in CMAJ on the effects of supportive follow-up on the rate at which patients quit smoking cigarettes. We agree with some of their general sentiments about the need for establishing a consensus on the evaluation of smoking cessation programs. More specifically, we defend the particular analysis originally used, given the state of knowledge and constraints on the study. We examine their main objections: the definition of successful cessation, the design of the study, the exclusion of patients lost to follow-up, the methods of statistical analysis used and the strength of more recent evidence on the usefulness of follow-up visits. We believe that the role of supportive follow-up deserves further evaluation.

Evaluation Studies as Topic↗
PubMed1987

A smoking cessation intervention program for family physicians.

Family physicians are able to approach many patients who smoke but are often hesitant to help them quit. Lack of knowledge about effective interventions is a major reason for this hesitancy. The important components that have been tested in physician-initiated smoking cessation interventions are advice to quit, information about the risks of smoking and techniques for quitting, nicotine gum, setting a date for quitting and offers of supportive follow-up visits. We describe a cessation program developed for family physicians that incorporates these factors into three types of visits over a 2-month period: the challenge visit, which occurs during a regular office visit and focuses on advice and setting a date to quit; the quit-date visit, which involves instructing patients on the proper use of nicotine gum, if applicable, and confirming their desire to quit; and four supportive follow-up visits, which provide continuing encouragement for 2 months and allow physicians to monitor withdrawal symptoms, relapses and other problems. Such a program can be effectively incorporated into a general practice.

Chewing Gum↗
PubMed1986

Smoking cessation in family practice: the effects of advice and nicotine chewing gum prescription.

The efficacy of physician anti-smoking intervention with 289 patients in a family practice setting was assessed. The design included two treatment conditions, physician advice and physician advice plus the offer of nicotine chewing gum (NCG) prescription. A no-advice group permitted assessment of the effects of repeated testing. The NCG group had higher rates of abstinence at all follow-up points, but the difference approached statistical significance at 3 months only (p less than .10). Comparison of those who actually used NCG to all other groups revealed significantly more users were abstinent at 1- and 3-month follow-up. A similar pattern occurred for proportion attempting cessation and smoking reduction. A dose-response relationship of gum use to outcome was identified. Long-term users (greater than 20 days) had 86% abstinence at 3 months versus 18% for short-term users. Thus, NCG does appear to have a role in family practice for promoting short-term cessation.

Adolescent↗
PubMed1985

Are social-psychological smoking prevention programs effective? The Waterloo study.

Recent evaluations of smoking prevention programs have suggested considerable promise for curricula emphasizing resistance of social influences. The present study extends these evaluations by addressing key methodological limitations in previous work. Twenty-two matched schools were randomized to experimental and control conditions. Grade 6 students received a 6-week core curriculum, plus additional sessions through Grades 7 and 8. Questionnaires, and saliva samples to validate self-reported smoking behavior, were collected at five times over the 2-year study period. Cross-sectional and longitudinal analyses examined program impact for five levels of initial smoking experience, ranging from "never smoker" through regular, weekly smoker. Significant program effects were documented, most clearly for those having some experience with smoking before the program began and for those with smoking peer and family models. This study provides the methodologically most rigorous test to date of social influence programs for smoking prevention and documents for the first time significant effects for those at high risk for smoking.

Adolescent↗
PubMed1982

Overcoming design problems in evaluating health behavior programs.

The increasing importance of high-quality evaluative research on health lifestyle change programs is established. Failure to ask the right evaluative research questions and problems of research design are identified as two major reasons for the dearth of well-controlled, interpretable evaluations in this area. Thirteen issues of research design that need to be considered if interpretable answers to evaluative research questions are to be obtained are identified and discussed. Solutions to these problems and design recommendations are offered.

Attitude to Health↗
PubMed1977

Satiation and sensory deprivation combined in smoking therapy: some case studies and unexpected side-effects.

Two promising techniques for smoking reduction, sensory deprivation and stimulus satiation, were applied in combination to five smokers. All were successful initially in achieving abstinence and four ultimately in maintaning abstinence. The issue of possible side-effects is worth considering. Quitting per se and both satiation and sensory deprivation may be stressful and as a result may potentially produce negative side effects. The observation of positive side-effects in these cases balances this possibility to some extent.

Adult↗
PubMed1976

The influence of interviewer self-disclosure and verbal reinforcement on personality tests.

The effects of prior interview experiences on subsequent test responding were examined by comparing the influence of three interviewer behaviors: interviewer self-disclosure, interviewer verbal reinforcement of self-referent statements, and direct instructions to be self-disclosive. Performance was contrasted with a control interview condition characterized by no interviewer self-disclosure or self-referent reinforcement and with a no-interview condition. Responses on measures of self-disclosure and anxiety indicated that female Ss tended to be more self-disclosive than males in general, but were relatively uninfluenced by experimental condition. For male Ss, verbal reinforcement increased self-disclosure relative to the interviewer seld-disclosure condition. Interviewer self-disclosure was shown to result in more favorable perceptions of the self and the interviewer, particularly for males, and greater social evaluative anxiety for females. Both these factors are discussed as possibly counteracting the modelling effects of interviewer self-disclosure. An interpretation of the results in terms of interactions between S sex, interviewer sex, and experimental condition is proposed and implications for related research discussed.

Anxiety↗