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Biomedical subjects

Daniel M Bolt

Publications and source records attributed to Daniel M Bolt.

5 recordsLinked to original sources

Optimizing smoking cessation pharmacotherapy and counseling for adult primary care patients: a factorial randomized controlled trial.

BACKGROUND: Even with the most effective smoking cessation pharmacotherapies (i.e., varenicline or combination nicotine replacement [C-NRT]), the majority of people ultimately return to smoking. This research explored how to optimize the use of varenicline and C-NRT to promote smoking cessation. METHODS: Primary care patients participated in a 2x2x2x2 factorial experiment that evaluated 4 factors: 1) Medication Type (Varenicline vs. C-NRT [patch + mini-lozenge]), 2) Preparation (pre-quit) Medication (4 Weeks vs. Standard); 3) Medication Duration (Extended [24 weeks] vs. Standard [12 weeks]); and 4) Counseling Type (Cessation Counseling [4 sessions] vs. Referral Support [2 sessions focused on use of referral resources]). This study was discontinued prior to reaching the proposed sample size (N = 608) due to pandemic-related budgetary constraints. RESULTS: Participants (N = 496) were 55% women and 45.6% Black individuals. There were no statistically significant main effects of the 4 factors on abstinence at 12, 26 or 52 weeks. There was a 3-way interaction between Medication Type, Preparation Medication, and Counseling Type (p = 0.04) predicting the primary outcome of biochemically confirmed abstinence at 52 weeks; cessation counseling vs. referral support improved varenicline quit rates when 4 weeks versus 1 week of pre-quit medication was offered. For C-NRT, counseling type did not significantly improve quit rates regardless of the use of preparation medication. CONCLUSIONS: There was no robust evidence that enhanced pre-quit or extended duration of varenicline or C-NRT increased abstinence rates. More intensive counseling may support cessation for different pharmacotherapy regimens. Given the lack of consistent findings, this research should be viewed as exploratory to guide future research.

Humans↗

Activities, engagement, and emotion in after-school programs (and elsewhere).

Experiences that are deeply engaging and enjoyable, engender full concentration, and present a balance between challenge and skill promote children's development. This chapter describes a study that sought to identify the kinds of settings and activities that foster engagement and, by extension, positive youth development. The after-school experiences of 191 ethnically diverse youth living in three states, some of whom participated in after-school programs and some of whom did not, were studied. Youth were equipped with logbooks and watches that were programmed to signal at random times. When signaled, youth recorded their location, social partners, activity, and feelings. The study found pervasive differences in the experiences at programs and elsewhere. Youth spent more time in academic and arts enrichment, organized sports and physical activities, community service, and homework at programs versus elsewhere, and they spent less time eating and watching TV at programs. They also reported higher levels of motivation, engagement, and positive affect at programs. At the same time, there were few differences in activities, emotions, effort, or motivation of program participants and nonparticipants when both groups were elsewhere. The similarities in these experiences while elsewhere suggest that the program context, not differences in youth characteristics or interests, was responsible for the feelings of engagement that were reported at programs.

Adolescent↗

A multiple motives approach to tobacco dependence: the Wisconsin Inventory of Smoking Dependence Motives (WISDM-68).

The dependence construct fills an important explanatory role in motivational accounts of smoking and relapse. Frequently used measures of dependence are either atheoretical or grounded in a unidimensional model of physical dependence. This research creates a multidimensional measure of dependence that is based on theoretically grounded motives for drug use and is intended to reflect mechanisms underlying dependence. Data collected from a large sample of smokers (N = 775) indicated that all 13 subscales of the Wisconsin Inventory of Smoking Dependence Motives (WISDM-68) have acceptable internal consistency, are differentially present across levels of smoking heaviness, and have a multidimensional structure. Validity analyses indicated the WISDM-68 subscales are significantly related to dependence criteria such as smoking heaviness and to 4th edition Diagnostic and Statistical Manual of Mental Disorders symptoms of dependence and relapse.

Humans↗

A multigroup item response theory analysis of the psychopathy checklist--revised.

Item response theory was used to investigate the functioning of the Psychopathy Checklist-Revised (PCL-R; R. D. Hare, 1991, 2003) in several offender populations. With male criminal offenders (N=3,847) as a reference group, differential item functioning analyses were performed for 3 comparison groups: female criminal offenders (N=1,219), male forensic psychiatric patients (N=1,246), and male criminal offenders scored from file reviews (N=2,626). Results are discussed in the context of the 2-factor, 4-facet model for the PCL-R (R. D. Hare, 2003; J. Parker, G. Sitarenios, & R. D. Hare, 2003). Application of a multigroup graded response model to all 4 groups suggests scalar equivalence may hold at least approximately for each population, although the PCL-R provided slightly greater information about the latent trait of psychopathy for male criminal offenders scored from the standard procedure.

Adult↗

A multidimensional model for characterizing tobacco dependence.

The standard tool for assessing tobacco dependence is the Fagerström Tolerance Questionnaire (FTQ) or its more recent variant, the Fagerström Test for Nicotine Dependence (FTND). Although both of these scales reportedly assess physiological dependence on nicotine, they might not tap some facets of dependence, particularly psychosocial factors. To determine whether tobacco dependence exhibits multidimensional properties, we examined two existing, independent data sets, one from SRI International (n=443) and another from the University of Michigan (n=445). Based on our knowledge from existing literature, standard psychometric statistical analyses, and results from exploratory factor analysis using SRI's data set, we identified two competing models for dependence representing a hybrid of the FTQ/FTND and the Smoking Motives Questionnaire. We then examined these models using confirmatory factor analysis with data from the University of Michigan. We characterized the final model by five first-order factors, each consisting of two to four items, and one higher-order factor. The first-order factors were termed stimulation, automaticity, sedation, psychosocial motives, and morning smoking; the higher-order factor, tobacco dependence, underlay each of the first-order factors. The ranges of interitem correlations and Cronbach's alpha estimates of internal consistency for the first-order factors were .34 - .68 and .64 - .81, respectively. Results of these analyses support the hypothesis that tobacco dependence is multidimensional.

Adult↗