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Biomedical subjects

S J Curry

Publications and source records attributed to S J Curry.

49 records · Page 3Linked to original sources
PubMed1993

Self-help interventions for smoking cessation.

Self-help interventions for smoking cessation are an important bridge between the clinical and public health approaches to smoking cessation. The current literature on self-help interventions is encouraging but incomplete. Although their quit rates are lower than those of more intensive programs, self-help interventions could have a large public health impact because of their potential for widespread distribution. Studies comparing self-help to more intensive treatment suggest that long-term cessation rates for self-help programs are potentially as high as rates for face-to-face interventions, with lower quit rates for self-help programs that are likely due to differences in program adherence. Tailored materials and personalized adjuncts (e.g., written feedback or telephone counseling) that promote program adherence may increase cessation rates.

Follow-Up Studies↗
PubMed1992

An application of the stage model of behavior change to dietary fat reduction.

To assess the applicability of Prochaska and DiClemente's stage model to dietary change, stage of dietary fat reduction was assessed in two samples of adults. Results were consistent across the two samples. Males and females differed in their distribution across five stages of change, with more males than females in a precontemplation stage and more females than males in a maintenance stage. Significant positive correlates with stage for men and women were age, education, body mass index, number of chronic conditions and being told one has a high serum cholesterol. For both genders, stage of dietary fat reduction was significantly associated with percent of calories from fat, even when controlling for demographic and health status covariates.

Adult↗
PubMed1992

Postpartum relapse to smoking: a prospective study.

A substantial proportion of women who quit smoking during pregnancy will relapse in postpartum. In order to better understand the psychosocial factors which precipitate relapse to smoking we conducted a prospective study of postpartum smoking relapse among a cohort (N = 106) of women who quit smoking during pregnancy. Participants were surveyed by telephone after the 28th week of pregnancy, and at 6 weeks and 6 months postpartum. Point prevalence estimates of smoking relapse indicated that at 6 weeks and 6 months follow-up, 24% (n = 26) and 40% (n = 42), respectively, of the women had returned to regular smoking. Spouse's smoking status, social support, decreases in self-efficacy, and the types of coping strategies used to resist smoking in pregnancy and postpartum predicted relapse to smoking in postpartum. Longitudinal data indicated that relapse occurred relatively gradually suggesting that early postpartum is not too late to encourage new mothers to remain abstinent.

Adolescent↗
PubMed1991

Evaluation of intrinsic and extrinsic motivation interventions with a self-help smoking cessation program.

Personalized feedback and a financial incentive, developed from an intrinsic/extrinsic motivation framework, were evaluated as adjuncts to self-help materials for smoking cessation. Ss (N = 1,217) were randomized to 4 treatment groups and were followed up at 3 and 12 months. Consistent with hypotheses derived from the motivation framework, the financial incentive increased the use of self-help materials, did not increase cessation rates among program users, and was associated with higher relapse rates among those who did manage to quit. The personalized feedback increased both smoking cessation and use of the materials 3 months after distribution of the materials. Continuous abstinence (abstinence at 3 and 12 months) in the group that received the personalized feedback alone was twice the rate of the other groups.

Adult↗
PubMed1988

A comparison of alternative theoretical approaches to smoking cessation and relapse.

Two theoretical approaches to smoking cessation were compared. Participants were randomly assigned either to (a) a traditional treatment program that used contingency contracting and that emphasized the necessity for absolute abstinence (AA) or to (b) a relapse-prevention (RP) treatment that focused on gradual acquisition of nonsmoking skills. It was hypothesized that participants in the RP treatment would be less successful initially but would have better maintenance skills and thus would relapse less during a 1-year follow-up period. Each program was evaluated in two formats: group-based treatment and self-help materials. Results indicated comparable 1-year abstinence rates for all treatments, although more participants dropped out of the self-help formats. Participants in the RP intervention were more likely to lapse sooner after quitting and were more likely to quit again during the 1-year maintenance period. Exploratory analyses of successful participants suggested that women were more successful in the RP program and that men had greater success with the AA approach.

Adult↗
PubMedDate not supplied

Reasons for quitting: intrinsic and extrinsic motivation for smoking cessation in a population-based sample of smokers.

An intrinsic-extrinsic model of motivation for smoking cessation is extended to a population-based sample of smokers (N = 1,137), using a previously validated Reasons for Quitting (RFQ) scale. Psychometric evaluation of the RFQ replicated the model that includes health concerns and self-control as intrinsic motivation dimensions and immediate reinforcement and social influence as extrinsic motivation dimensions. Compared to volunteers, the population-based sample of smokers reported equivalent health concerns, lower self-control, and higher social influence motivation for cessation. Within the population-based sample, women compared to men were less motivated to quit by health concerns and more motivated by immediate reinforcement; smokers above age 55 expressed lower health concerns and higher self-control motivation than smokers below age 55. Higher baseline levels of intrinsic relative to extrinsic motivation were associated with more advanced stages of readiness to quit smoking and successful smoking cessation at a 12-month follow-up. Among continuing smokers, improvement in stage of readiness to quit over time was associated with significant increases in health concerns and self-control motivation.

Adult↗
PubMedDate not supplied

Implementing a dietary intervention in primary care practice: a process evaluation.

OBJECTIVES: Physicians acknowledge the need to advise their patients about dietary habits, but they may not have the training or tools to do this efficiently. In the context of a randomized trial, we investigated the feasibility of enlisting physicians to implement a dietary intervention in the primary care setting. METHODS: Physicians from 14 primary care practices were assigned via randomization to introduce a self-help booklet to promote dietary change at routine appointments. Delivery of the booklet was recorded by these intervention physicians at the clinic appointment; intervention participants were asked 3 months later in a telephone interview about whether they received and used the booklet. RESULTS: According to physician documentation, 95% of intervention participants who kept an appointment (n = 935) received the booklet; among participants completing a 3-month interview (n = 890), 96% reported the same. However, only about 50% of participants reported receiving the booklet from their physician; the remainder received the booklet from other clinic staff. Overall, 93% reported reading at least part of the booklet. Use of the booklet varied little whether it was delivered by a physician or staff person, but it was more likely to be read as time spent discussing the booklet increased. CONCLUSIONS: Physician cooperation and evidence of intervention effectiveness support the use of primary care for the delivery of interventions to change diet; training the entire health team and repeating dietary advice at subsequent visits may improve the success of such interventions.

Diet Surveys↗
PubMedDate not supplied

Effect of health lifestyle pattern on dietary change.

PURPOSE: To examine the effect of lifestyle on the effectiveness of a low-intensity dietary intervention. DESIGN: A secondary data analysis was performed using data from the Eating Patterns Study, a randomized controlled trial that found that self-help materials with physician advice was effective in changing dietary intake and behavior. SETTING: Primary care clinics in a large health maintenance organization. SUBJECTS: A total of 2111 patients with a routine scheduled appointment with their primary care physicians. MEASURES: Participants were grouped into one of six health lifestyle patterns based on similarities in baseline measures of alcohol intake, smoking, diet quality, and exercise. Within each lifestyle pattern, changes from baseline in usual fat and fiber intake (based on a food frequency) and a fat and fiber behavior score were compared at 3 months and 12 months for intervention vs. control participants. INTERVENTION: Self-help materials delivered by a physician with advice to change diet. RESULTS: Intervention participants in the fitness lifestyle group made the largest changes relative to controls for each dietary outcome at 3 and 12 months. For intervention participants defined by their alcohol intake or current smoking, either no changes in diet were observed compared with controls, or early changes were not sustained over time. Intervention-control comparisons within the remaining lifestyle patterns showed smaller dietary changes compared with the fitness lifestyle. This finding was similar to previously published results. CONCLUSIONS: This randomized controlled trial had limited power to detect subgroup differences; however, these results suggest that lifestyle patterns may be useful in the development of effective, targeted interventions to change behavior.

Data Collection↗
PubMedDate not supplied

Women's knowledge and attitudes about genetic testing for breast cancer susceptibility.

OBJECTIVE: To assess female primary care patients' knowledge about breast cancer genetics and attitudes toward genetic testing. DESIGN: Self-administered survey. PARTICIPANTS: A convenience sample of 91 female patients awaiting appointments at a large primary care clinic of Group Health Cooperative in Seattle, Washington. RESULTS: Forty-seven percent of women had read or heard almost nothing about genetic susceptibility testing, and most did not know the answers to questions that assessed knowledge about breast cancer genetics. Eighty-one percent "somewhat" or "strongly" agreed that testing should be offered to everyone; women who had heard or read about genetic testing for breast cancer were more likely to agree that genetic testing should be offered only to people who have a reason to think that they have an altered gene. When asked whether they planned to have genetic testing for breast cancer, many women said "probably or definitely yes" (71% would do so if insurance covered the cost; 44% would do so even if they had to pay out-of-pocket). CONCLUSIONS: Although most women knew little about genetic testing, many expressed interest in being tested and believed that it should be offered to everyone. Primary care providers may be asked to educate women about cancer genetics and appropriate use of susceptibility testing.

Adolescent↗
PubMedDate not supplied

Exploring environmental barriers to participation in mammography screening in an HMO.

Despite an upward trend in mammography screening rates, rates among some demographic subgroups and rates of annual mammography remain low. Behavioral-based interventions which move beyond invitational strategies to help women overcome their personal barriers may be necessary to increase participation. We developed a heuristic model based on the Health Belief Model and Social Learning Theory with the central hypothesis that the relative importance of environmental barriers in predicting screening behavior is a function of the woman's perceived risk, preventive orientation, and/or concerns about mammography. We completed telephone interviews with 313 women who did not obtain a mammogram and 350 women who had a mammogram within 365 days of an invitation from a Health Maintenance Organization-based breast cancer screening program. Results of multivariate analyses indicated that perceived risk did not mitigate the influence of logistic inconveniences associated with obtaining a mammogram. Preventive orientation as measured by smoking status interacted with belief that symptoms are a necessary prerequisite to a mammogram as a powerful predictor of participation; the greatest negative impact of concerns on participation was found among smokers. A similar relationship between concerns and participation, although only marginally significant, was observed among those who perceived it to be difficult to get to the screening center. Implications of the results for development of behavioral interventions and additional research are discussed.

Breast Neoplasms↗
PubMedDate not supplied

Assessment of community-level influences on individuals' attitudes about cigarette smoking, alcohol use, and consumption of dietary fat.

A basic premise of community-based health promotion is that enduring changes in health behaviors are facilitated by changing community norms or the standards of acceptable behavior in the community. We examine whether community-level influences on individuals' normative attitudes can be related to cigarette smoking, alcohol consumption, and dietary fat intake. We conducted a random-digit dialing survey of 8,849 adults in 15 communities in the western United States as part of the evaluation of the Henry J. Kaiser Family Foundation Community Health Promotion Grant Program. We found independent associations among attitudes for tobacco, alcohol, and diet and both individual-level and community-level characteristics. A significant community effect on attitudes remained even when we controlled for individual demographics and health behaviors, as well as for the overall prevalence of the target health behavior in the community. The specific community characteristics that account for this effect were not clear in our analyses, suggesting that influential characteristics vary from community to community.

Adult↗