Biomedical subjects

Janet L Thomas

Publications and source records attributed to Janet L Thomas.

12 recordsLinked to original sources

PubMed2006

Perceptions and beliefs about body size, weight, and weight loss among obese African American women: a qualitative inquiry.

The purpose of this qualitative study was to explore perceptions and beliefs about body size, weight, and weight loss among obese African American women in order to form a design of weight loss intervention with this target population. Six focus groups were conducted at a community health clinic. Participants were predominantly middle-aged with a mean Body Mass Index of 40.3 +/- 9.2 kg/m(2). Findings suggest that participants (a) believe that people can be attractive and healthy at larger sizes; (b) still feel dissatisfied with their weight and self-conscious about their bodies; (c) emphasize eating behavior as the primary cause for weight gain; (d) view pregnancy, motherhood, and caregiving as major precursors to weight gain; (e) view health as the most important reason to lose weight; (f) have mixed experiences and expectations for social support for weight loss; and (g) prefer treatments that incorporate long-term lifestyle modification rather than fad diets or medication.

Adult↗

PubMed2006

Reported distress associated with concern about a cigarette smoker.

It is well documented that concerned others of alcohol abusers report distress associated with the substance user's behavior. No previous study has examined distress associated with concern for someone who smokes cigarettes. To investigate this association, college students, ages 18-24 (N=1719), completed a survey assessing whether or not they were close to someone who smokes whom they thought should quit and the level of distress they experienced regarding this person's smoking. 827 (48.1%) respondents endorsed knowing a smoker whom they thought should quit and 60% reported experiencing at least some distress regarding this person's smoking. From multivariate analysis, the presence of distress (any vs. none) was associated with female gender (OR=1.8, 95% C.I. 1.2, 2.5, p=0.001), never tobacco user (OR=2.0, 95% C.I. 1.4, 2.9, p<0.001), and elevated Perceived Stress Scale score (OR=1.05, 95% C.I. 1.02, 1.08, p<0.001, per 1 unit increase in PSS score). These findings contribute to our understanding of how smoking impacts the psychological well being of another and is intended to stimulate future research investigating the potential for distressed individuals to serve as change agents in tobacco control efforts.

Adolescent↗

PubMed2006

Measuring nicotine dependence among smokeless tobacco users.

The objective of this study was to assess the concurrent validity of the FTQ-ST and the DIS-IV diagnosis of nicotine dependence among 68 adult ST users enrolled in a randomized, controlled clinical trial of bupropion SR. FTQ-ST scores were not found to differ between those with and without a current DIS-IV diagnosis of nicotine dependence (7.4+/-2.1 vs. 6.8+/-2.8, P=0.325). For all possible FTQ-ST cutoff scores, the observed agreement between the FTQ-ST and the DIS-IV was not found to be different from that expected due to chance. FTQ-ST total scores were positively correlated with serum cotinine (Spearman's r=0.40, P<0.001), amount of tobacco used (r=0.51 and r=0.41 for average dips/chews per day; average tins/pouches per week, respectively, P<0.001), and a reduced likelihood of abstinence at 3 months (OR=0.76, 95% C.I. 0.61-0.96; P=0.019). Participants meeting DIS-IV criteria had lower cotinine concentrations than those without this diagnosis (411+/-263 ng/ml vs. 493+/-246 ng/ml; P=0.042). Poor concordance was observed between the FTQ-ST and the DIS-IV in the assessment of nicotine dependence in ST users.

Adult↗

PubMed2006

Homelessness and smoking cessation: insights from focus groups.

Smoking prevalence among homeless persons is approximately 70%, yet little is known about tobacco use patterns or smoking cessation practices in this population. We assessed smoking attitudes and behaviors, psychosocial and environmental influences on smoking, barriers to and interest in quitting, and preferred methods for cessation among some homeless smokers. Six 90-min focus groups of current smokers (N = 62) were conducted at homeless service facilities. Participants had a mean age of 41.5 years (SD = 9.3), were predominantly male (69.4%) and African American (59%), and smoked an average of 18.3 cigarettes/day. Although most reported that they were motivated to quit, a number of barriers to quitting were identified. Participants reported that the pervasiveness and social acceptance of tobacco use in homeless settings contributed to smoking more cigarettes per day, adopting alternative smoking behaviors such as smoking cigarette butts and making their own cigarettes, and experiencing difficulty in quitting. High levels of boredom and stress also were cited as reasons for continued smoking. Smoking frequently occurred in combination with alcohol or illicit drug use or to achieve a substitute "high." Most participants (76%) reported that they planned to quit smoking in the next 6 months. Many were interested in using pharmacotherapy in combination with behavioral treatments. Results suggest that, although motivated to quit smoking, homeless smokers are faced with unique social and environmental barriers that make quitting more difficult. Interventions must be flexible and innovative to address the unique needs of homeless smokers. Smoking restrictions at homeless service facilities and funding for smoking cessation assistance in this underserved population may help to reduce prevalence.

Adult↗

PubMed2006

Smoking cessation in homeless populations: a pilot clinical trial.

This study, which tested two motivational interviewing treatment approaches, assessed the feasibility of conducting a community-based smoking cessation intervention among homeless smokers. Participants (N = 46) were recruited from multiple facilities in the Kansas City area and were randomized to two counseling conditions in which they received five individual motivational interviewing sessions, six group meetings, and their choice of 8 weeks of 21-mg nicotine patch or 4-mg nicotine lozenge. The two counseling conditions consisted of motivational interviewing targeted either to smoking behaviors exclusively (smoking only) or to smoking and other addictions or life events that could affect ability to quit (smoking plus). Group meetings were designed to provide educational information and social support. Measures of feasibility assessed included the proportion of participants who returned for randomization among those eligible, adherence to prescribed nicotine replacement therapies, retention rates at the week 26 final study visit, and biochemically verified 7-day abstinence at week 26. Most participants (69.6%) chose nicotine patches, and 32% of those participants reported using at least four patches per week. Carbon monoxide verified 7-day abstinence rates in the smoking-only and smoking-plus groups were 13.04% and 17.39% (ns), respectively, at week 8 and 8.70% and 17.39% (ns), respectively, at week 26. Participants who used at least four patches per week were more likely to have quit at 8 weeks than were those who used fewer patches (33.3% vs. 10.5%, p = .30). Results support the feasibility of conducting a smoking cessation intervention among homeless smokers. Findings also show promising effects for nicotine replacement therapy and counseling in this population. Developing programs to improve smoking cessation outcomes in underserved populations is an essential step toward achieving national health objectives and for ultimately reducing tobacco-related health disparities.

Adult↗

PubMed2005

Development and preliminary evaluation of a measure of support provided to a smoker among young adults.

Most studies indicate a positive association between social support and smoking cessation. However, clinic-based interventions to increase support for stopping smoking have had limited success. Prior research has emphasized the smoker's perceptions of support received for smoking cessation while less attention has focused on support persons' reports of supportive behaviors provided to a smoker. This study examined select psychometric properties of the Support Provided Measure (SPM), a self-report questionnaire designed by the investigative team to assess supportive behaviors provided to a smoker. The SPM was administered to a college sample (N=771; 67% female) of young adults, aged 18 to 24 years, who reported knowing a smoker whom they thought should quit smoking. Results indicate that, in this sample, the SPM has a two-factor structure with good internal consistency reliability (Cronbach's alpha=0.77) and appears to assess a wide range of individual differences in the provision of support. Demographic correlates associated with SPM scores are described and suggestions for future research are offered.

Adolescent↗

PubMed2004

Beliefs and attitudes regarding smoking among young adult Latinos: a pilot study.

BACKGROUND: Tobacco use interventions for young adult Latinos have not yet been developed. This qualitative pilot study employed semistructured interviews to assess beliefs and attitudes regarding tobacco use interventions among young adult Latinos. METHODS: The size of the individual or group interviews ranged from one to four participants each. Participants were 19 Latino adults (37% female), 18-24 years of age. The interviews were videotaped and transcribed for analysis of common themes. RESULTS: Use of tobacco in Latino cultures is most common among men, and most prevalent in social situations. Tobacco use is discouraged by and often hidden from elder family members. Participants acknowledged adverse health effects of tobacco use. Barriers to preventing and stopping tobacco use are its acceptance among peers and its use during social situations. Although some Latinos would like to quit, cultural barriers included lack of knowledge, unwillingness to ask for help, and perceived deficiency of Spanish language resources regarding tobacco dependence interventions. Participants lacked understanding of how research might benefit their cultural community. CONCLUSION: Cultural attitudes toward tobacco and perceived barriers to quitting will be useful in developing tobacco use interventions for Latinos.

Adolescent↗

PubMed2004

Training support persons to help smokers quit: a pilot study.

BACKGROUND: Evaluate the feasibility, acceptability, and potential efficacy of a skills-training intervention for adults interested in helping someone to stop smoking (i.e., support persons). METHODS: Sixty adult support persons (77% female) were directly recruited from the community and randomly assigned to this intervention (manual plus five weekly group-based sessions) or a control condition (one-page leaflet). All intervention and outcome assessments occurred through the support persons. Assessments occurred at weeks 0 (baseline), 6 (end of treatment), 12, and 24. The study was conducted from 1998 to 2001; data collection occurred from 1999 to 2000. Outcomes were ratings of treatment acceptability, recruitment and retention rates, supportive behaviors provided to the smoker, and smoking behavior change in the smoker as reported by the support person. RESULTS: Support persons were recruited in a timely manner and study retention rates were high. Support persons in skills training showed significant increases in their supportive behavior scores compared with control subjects at weeks 6 and 12. Although not statistically significant, the skills-training intervention was associated with more quit attempts, greater improvement in stage of change, and higher 7-day point prevalence abstinence rates in the smokers than the control condition. CONCLUSIONS: A skills training intervention for support persons is feasible and acceptable. Further studies are needed to test the efficacy of this approach for smoking cessation.

Adolescent↗

PubMed2004

Reported willingness among adolescent nonsmokers to help parents, peers, and others to stop smoking.

BACKGROUND: This study of 1025 adolescent nonsmokers aged 11-19 years examined level of interest and factors associated with reported willingness to help someone stop smoking. METHODS: Data were collected from a survey distributed primarily in the schools at four geographic and ethnically diverse study sites. RESULTS: A total of 692 adolescents identified someone close to them who smokes whom they thought should quit. Of these, 90% reported that they would be willing to help this person stop smoking. Multivariate predictors of willingness to help were female gender, less difficulty reading English, and greater level of comfort with talking to the smoker about their smoking. The smoker that the adolescents were willing to help was most often a parent or same age friend. CONCLUSIONS: If this strong interest among adolescents could be tapped, engaging teens as support persons could be a novel public health approach to reaching parents, adolescents, and other smokers in the population.

Adolescent↗

PubMed2004

Preliminary findings on the development of a measure of supportive behaviors provided by support persons to help someone stop smoking.

Although studies indicate a positive association between social support and smoking cessation, clinic-based interventions to increase support for stopping smoking have had limited success. Prior studies have primarily assessed the smokers' perceptions of support received with little attention paid to the support person's reports of support provided. To address this limitation, this study reports on the development and testing of the 22-item Support Interview, a process measure designed to assess supportive behaviors provided to a smoker. The rationale for the conceptual underpinning of the measure and item selection is provided. Preliminary psychometric properties of the instrument (i.e., internal consistency reliability, item-change scores, factor structure) are described. Clinical and public health implications for the use of measures of support provided for behavior change are discussed.

Adult↗

PubMed2002

Prevention of tobacco use in adolescents: review of current findings and implications for healthcare providers.

This paper reviews recent research on adolescent smoking initiation and youth tobacco prevention and control strategies. Gender, ethnicity, family factors, and genetics are associated with smoking initiation and adolescent tobacco use. Evidence indicates that comprehensive tobacco control programs are an effective strategy for reducing adolescent smoking, and even modest gains from prevention and cessation efforts could lead to substantial reductions in the morbidity and mortality costs of smoking. Clinicians have an important role in prevention and treatment of tobacco use in adolescents, and the rate of delivery of clinical preventive services in this area should be increased. Consequently, clinicians working with adolescents should be familiar with established guidelines regarding tobacco use prevention and treatment and use general outpatient office visits as an important opportunity to prevent tobacco use.

Adolescent↗

PubMedDate not supplied

Is smoking related to body image satisfaction, stress, and self-esteem in young adults?

OBJECTIVES: To examine the association of smoking and gender with body image satisfaction, perceived stress, and self-esteem in young adults. METHODS: Respondents completed a survey consisting of Perceived Stress Scale, Body-Areas Satisfaction Scale, Rosenberg Self-Esteem Scale, and the Positive and Negative Affect Schedule. Current smokers (n = 483) and never smokers (n = 973) are included. RESULTS: Smoking and female gender were independently associated with higher perceived stress (P < 0.001). Female gender was associated with lower body image satisfaction and lower self-esteem (P < 0.001). Current smoking was associated with lower self-esteem (P = 0.007). CONCLUSION: Smoking treatment should include stress management and self-esteem and body image improvement.

Adolescent↗