Biomedical subjects

Jennifer B McClure

Publications and source records attributed to Jennifer B McClure.

9 recordsLinked to original sources

PubMed2006

Interest in an online smoking cessation program and effective recruitment strategies: results from Project Quit.

BACKGROUND: The Internet is a promising venue for delivering smoking cessation treatment, either as a stand-alone program or as an adjunct to pharmacotherapy. However, there is little data to indicate what percent of smokers are interested in receiving online smoking cessation services or how best to recruit smokers to Internet-based programs. OBJECTIVE: Using a defined recruitment sample, this study aimed to identify the percentage of smokers who expressed interest in or enrolled in Project Quit, a tailored, online, cognitive-behavioral support program offered with adjunctive nicotine replacement therapy patches. In addition, we examined the effectiveness of several individual-level versus population-level recruitment strategies. METHODS: Members from two large health care organizations in the United States were invited to participate in Project Quit. Recruitment efforts included proactive invitation letters mailed to 34533 likely smokers and reactive population-level study advertisements targeted to all health plan members (> 560000 adults, including an estimated 98000 smokers across both health care organizations). RESULTS: An estimated 1.6% and 2.5% of adult smokers from each health care organization enrolled in Project Quit. Among likely smokers who received proactive study invitations, 7% visited the Project Quit website (n = 2260) and 4% (n = 1273) were eligible and enrolled. Response rates were similar across sites, despite using different sources to assemble the invitation mailing list. Proactive individual-level recruitment was more effective than other forms of recruitment, accounting for 69% of website visitors and 68% of enrollees. CONCLUSIONS: Smokers were interested in receiving online smoking cessation support, even though they had access to other forms of treatment through their health insurance. Uptake rates for this program were comparable to those seen when smokers are advised to quit and are referred to other forms of smoking cessation treatment. In this sample, proactive mailings were the best method for recruiting smokers to Project Quit.

Adult↗

PubMed2006

Chlamydia screening in at-risk adolescent females: an evaluation of screening practices and modifiable screening correlates.

PURPOSE: To identify modifiable correlates of chlamydia screening that could offer intervention targets to enhance screening. METHODS: We surveyed a representative sample of primary care providers (n = 186) at an integrated healthcare delivery system to document their self-reported adherence to annual screening of sexually-active adolescents and to identify specific, modifiable constructs that were correlated with annual chlamydia screening. To cross-validate providers' self-report, we also used automated data to examine adolescent screening in an anonymous sample of primary care providers (n = 143). RESULTS: Forty-two percent of providers reported annual chlamydia screening of sexually-active adolescents. Univariate correlates of annual screening were: provider type (non-physician) (p = .01), female gender (p = .001), fewer years of clinical experience (p = .001), greater perceived knowledge about chlamydia (p = .001), greater confidence across a range of screening-related activities (p < or = .01), greater comfort recommending screening for sexually transmitted diseases (p = .001), and greater perceived patient comfort discussing sexual issues (p < .01). In multivariate analyses, providers' perceived knowledge, confidence, comfort, and perceived patient comfort continued to be significantly associated with annual chlamydia screening after controlling for other relevant provider characteristics. Self-reported screening practices were consistent with observed screening rates in the anonymous provider sample. CONCLUSIONS: Routine chlamydia screening among asymptomatic, at-risk adolescent females could be enhanced through additional intervention targeting specific provider attitudes and beliefs about chlamydia screening.

Adolescent↗

PubMed2006

Tailoring nicotine replacement therapy: rationale and potential approaches.

Nicotine replacement therapy (NRT) is an effective treatment for smoking cessation, but as with all such pharmacotherapies, the majority of smokers who use NRT products do not stop smoking or remain abstinent long term. Treatment outcome is affected by a range of individual-specific factors, as well as the pharmacokinetic profile of each NRT formulation. This has led to speculation that abstinence rates could be improved if NRT treatments were individually tailored to best match each individual's needs and preferences. There are also populations for whom special product and dosage considerations are warranted to maximise treatment safety.This paper reviews the rationale for NRT treatment, standard dose recommendations and recommendations for how to best match NRT treatment to the specific needs of individual smokers. We also review emerging evidence that genetic profiling may one day be a useful consideration for tailoring NRT treatment.

Animals↗

PubMed2005

Proactive, motivationally enhanced smoking cessation counseling among women with elevated cervical cancer risk.

Current treatment guidelines recommend that all smokers be given motivational or action-oriented counseling, as is appropriate to their readiness to quit smoking. The present study assessed the acceptability and impact of a proactively delivered, motivationally tailored phone counseling program targeted to women with elevated risk for cervical cancer. Female smokers with a recent abnormal pap exam or a colposcopy were contacted and invited to participate, regardless of their interest in quitting smoking. Participants were randomly assigned to usual care (UC) or UC plus motivationally enhanced phone counseling (MEC). The intervention was well received: 79% of eligible women enrolled (n = 275), and 90% completed at least three of four calls. Participation did not vary by baseline motivation to quit. Compared with control subjects, counseling participants were more likely to seek additional treatment services and had a higher 7-day point-prevalence abstinence rate at 6 months (20% MEC vs. 12% UC, p<.05). MEC impact was sustained at 12 months, but abstinence increased among the UC group (18% MEC vs. 20% UC, p = ns). There was no difference in repeated point-prevalence abstinence at 6 and 12 months (11% MEC vs. 10% UC, p = ns). Outcomes were similar in a subgroup of 229 women who, at baseline, were interested in quitting in the next 6 months.

Adult↗

PubMed2004

Cigarette smoking and nicotine dependence.

Tobacco use is the single most preventable cause of death, disability, and disease in the United States and is projected to be the leading cause of death and disability across all developed countries by the year 2020. Understanding nicotine dependence, its causes, consequences, and effective treatments is critical to the nation's public health agenda. This article presents a brief overview of nicotine dependence with particular emphasis placed on understanding what nicotine dependence is, why it occurs, how it is measured, and how it can be managed through effective treatments.

Adult↗

PubMed2002

Concomitant use of cigarettes and smokeless tobacco: prevalence, correlates, and predictors of tobacco cessation.

BACKGROUND: This study examined the characteristics, tobacco use patterns over time, and predictors of tobacco cessation among concomitant users of cigarettes and smokeless tobacco. METHODS: Participants were employed adults residing in the southeastern United States who participated in the Working Well cancer prevention trial. Participants were assessed at baseline and followed-up 4 years later. RESULTS AND CONCLUSIONS: The study yielded several key findings: (a) the prevalence of concomitant smoking and smokeless tobacco use was high among males and nonexistent among females, (b) the characteristics of concomitant users were relatively distinct from those of both smokers and smokeless tobacco users, (c) concomitant users exhibited substantial variability in their tobacco use patterns and were less likely to stop using tobacco than were smokers or smokeless tobacco users, (d) indicators of nicotine dependence predicted tobacco cessation for both smokers and smokeless tobacco users, but were largely unrelated to tobacco cessation among concomitant users, and (e) demographics, environmental variables, and measures derived from the transtheoretical model were not consistent predictors of tobacco cessation after controlling for nicotine dependence.

Adult↗

PubMed2002

Are biomarkers useful treatment aids for promoting health behavior change? An empirical review.

BACKGROUND: Nearly half of the leading causes of death in our society are attributable to behavioral risk factors. As such, it is critical that we continue to develop and refine effective interventions for health behavior change. Some researchers have suggested that using biomarkers to educate individuals about their health status and disease risk may be an effective strategy to promote behavior change. This tactic is also commonly employed by healthcare providers, but its empirical support is unclear. This article reviews the research literature to determine the effectiveness of using biomarker feedback to motivate and enable health behavior change. Potential limitations of this treatment strategy and issues requiring additional research are also discussed. METHODS: Articles were identified through PubMed (MEDLINE), PsychInfo, and the reference lists of pertinent manuscripts and book chapters. RESULTS: Eight published, randomized trials were identified that met criteria for review. The results of this work were mixed, but suggest that biological information conveying harm exposure, disease risk, or impaired physical functioning may increase motivation to change. Subsequent behavior change is also affected by the availability and intensity of concomitant treatment. CONCLUSIONS: Preliminary findings suggest that combining biomarkers with appropriate behavioral treatment may enhance health behavior change, but more research in this area is warranted.

Disease Transmission, Infectious↗

PubMed2002

Psychological distress among minority and low-income women living with HIV.

The growing incidence of HIV infection among low-income and minority women makes it important to investigate how these women adjust to living with HIV and AIDS. Psychological distress associated with HIV infection may compound the adjustment difficulties and increase the barriers to care associated with living in poverty. The authors surveyed 100 women who were receiving HIV care at a public hospital in the southeastern United States on measures of depression, anxiety, life stress, social support, and coping; they also assessed demographic and medical characteristics of the sample. Participants' annual incomes were low (87% < $10,000), and most participants were minorities (84% African American). Their levels of depression, stress, and anxiety symptoms were elevated relative to community norms. Greater anxiety and depression symptoms were associated with women who reported higher stress, using fewer active coping strategies, and perceiving less social support (ps < .001).

Adaptation, Psychological↗

PubMedDate not supplied

The relation between alcohol consumption and smoking abstinence: results from the Working Well Trial.

The current study examined the relation between drinking and smoking abstinence in a community-based sample from the Working Well Trial (WWT). At baseline, drinking level was related to smoking history (never, former, or current smoker; P < .0001) and abstinence history. Mean monthly alcohol consumption increased linearly with decreases in duration of recent abstinence (i.e., longest period quit in the past year among current smokers; P < .05) and current abstinence (i.e., time since quitting among former smokers; P < .0001), even controlling for relevant demographic factors. Among baseline smokers, lower beer consumption predicted smoking abstinence at 4-year follow-up (P< .01). A trend towards significance was found for total alcohol consumption (P = .06). The results suggest (a) a dose-response relation between baseline drinking and duration of smoking abstinence, and (b) that heavier drinkers are less likely to quit smoking over a 4-year period.

Adult↗