Motivation rulers for smoking cessation: a prospective observational examination of construct and predictive validity

Addiction Science & Clinical Practice

Edwin D Boudreaux⁴  Ashley Sullivan¹  Beau Abar⁴  Steven L Bernstein²  Adit A Ginde³  Carlos A Camargo¹ 

[1] Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, 02114, USA

[2] Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT, 06510, USA

[3] Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, 80045, USA

[4] Departments of Emergency Medicine, Psychiatry, and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, 01655, USA

关键词: Validity;    Reliability;    Stage of change;    Motivation;    Tobacco cessation;    Tobacco;   

Others  :  789374
DOI  :  10.1186/1940-0640-7-8

 received in 2011-10-12, accepted in 2012-06-08,  发布年份 2012

【 摘 要 】

Background

Although popular clinically, the psychometric properties of motivation rulers for tobacco cessation are unknown. This study examined the psychometric properties of rulers assessing importance, readiness, and confidence in tobacco cessation.

Methods

This observational study of current smokers was conducted at 10 US emergency departments (EDs). Subjects were assessed during their ED visit (baseline) and reassessed two weeks later. We examined intercorrelations between the rulers as well as their construct and predictive validity. Hierarchical multinomial logistic regressions were used to examine the rulers’ predictive ability after controlling for covariables.

Results

We enrolled 375 subjects. The correlations between the three rulers ranged from 0.50 (between Important and Confidence) to 0.70 (between Readiness and Confidence); all were significant (p < 0.001). Individuals in the preparation stage displayed the highest motivation-ruler ratings (all rulers F _{2, 363} ≥ 43; p < 0.001). After adjusting for covariables, each of the rulers significantly improved prediction of smoking behavior change. The strength of their predictive ability was on par with that of stage of change.

Conclusion

Our results provide preliminary support for the psychometric soundness of the importance, readiness, and confidence rulers.

【 授权许可】

   
2012 Boudreaux et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Miller WR, Rollnick S: Motivational Interviewing: Preparing People to Change Addictive Behavior. Guilford Press, New York; 1991.
• [2]NIDA: Principles of Drug Abuse Treatment. National Institute on Drug Abuse, Bethesda, MD; 1999.
• [3]Boudreaux ED, Baumann BM, Perry J, et al.: Emergency department initiated treatments for tobacco (EDITT): a pilot study. Ann Behav Med 2008, 36:314-325.
• [4]Lawendowski LA: A motivational intervention for adolescent smokers. Prev Med 1998, 27:39-46.
• [5]Taylor CB, Miller NH, Herman S, et al.: A nurse-managed smoking cessation program for hospitalized smokers. Am J Public Health 1996, 86:1557-1560.
• [6]Wakefield M, Olver I, Whitford H, Rosenfeld E: Motivational interviewing as a smoking cessation intervention for patients with cancer: randomized controlled trial. Nurs Res 2004, 53:396-405.
• [7]Prochaska JO, Velicer WF: The transtheoretical model of health behavior change. Am J Health Promot 1997, 12:38-48.
• [8]Rollnick S, Butler CC, Stott N: Helping smokers make decisions: the enhancement of brief intervention for general medical practice. Patient Educ Couns 1997, 31:191-203.
• [9]Cox LS, Cupertino AP, Mussulman LM, et al.: Design and baseline characteristics from the KAN-QUIT disease management intervention for rural smokers in primary care. Prev Med 2008, 47:200-205.
• [10]Patten CA, Decker PA, Dornelas EA, et al.: Changes in readiness to quit and self-efficacy among adolescents receiving a brief office intervention for smoking cessation. Psychol Health Med 2008, 13:326-336.
• [11]Kahler CW, Leventhal AM, Brown RA: Behavioral interventions in smoking cessation. In Principles of Addiction Medicine. Edited by Ries RK, Fiellin DA, Miller SC, Saitz R. Wolters Kluwer, Philadelphia, PA; 2009.
• [12]Biener L, Abrams DB: The Contemplation Ladder: validation of a measure of readiness to consider smoking cessation. Health Psychol 1991, 10:360-365.
• [13]Abrams DB, Herzog TA, Emmons KM, Linnan L: Stages of change versus addiction: a replication and extension. Nicotine Tob Res 2000, 2:223-229.
• [14]Chung T, Maisto SA, Mihalo A, et al.: Brief assessment of readiness to change tobacco use in treated youth. J Subst Abuse Treat 2011, 41:137-147.
• [15]Kozlowski LT, Porter CQ, Orleans CT, Pope MA, Heatherton T: Predicting smoking cessation with self-reported measures of nicotine dependence: FTQ, FTND, and HSI. Drug Alcohol Depend 1994, 34:211-216.
• [16]Boudreaux ED, Baumann BM, Camargo CA, O'Hea E, Ziedonis DM: Changes in smoking associated with an acute health event: theoretical and practical implications. Ann Behav Med 2007, 33:189-199.
• [17]Perez-Stable EJ, Marin G, Marin BV, Benowitz NL: Misclassification of smoking status by self-reported cigarette consumption. Am Rev Respir Dis 1992, 145:53-57.
• [18]Carlson LE, Bultz BD: Benefits of psychosocial oncology care: improved quality of life and medical cost offset. Health Qual Life Outcomes 2003, 1:1-9. BioMed Central Full Text
• [19]Ferguson JA, Patten CA, Schroeder DR, et al.: Predictors of 6-month tobacco abstinence among 1224 cigarette smokers treated for nicotine dependence. Addict Behav 2003, 28:1203-1218.
• [20]Hymowitz N, Sexton M, Ockene J, Grandits G: Baseline factors associated with smoking cessation and relapse. MRFIT Research Group. Prev Med 1991, 20:590-601.
• [21]Bandura A: Social Learning Theory. Prentice Hall, Englewood Cliffs, NJ; 1977.
• [22]Prochaska JO: Strong and weak principles for progressing from precontemplation to action on the basis of twelve problem behaviors. Health Psychol 1994, 13:47-51.
• [23]Rothman AJ: Toward a theory-based analysis of behavioral maintenance. Health Psychol 2000, 19:64-69.
• [24]Rothman AJ: "Is there nothing more practical than a good theory?": Why innovations and advances in health behavior change will arise if interventions are used to test and refine theory. Int J Behav Nutr Phys Act 2004, 1:11. BioMed Central Full Text
• [25]Schwarzer R, Luszczynska A, Ziegelmann JP, Scholz U, Lippke S: Social-cognitive predictors of physical exercise adherence: three longitudinal studies in rehabilitation. Health Psychol 2008, 27:S54-S63.
• [26]Boudreaux ED, Cydulka R, Bock B, Borrelli B, Bernstein SL: Conceptual models of health behavior: research in the emergency care settings. Acad Emerg Med 2009, 16:1120-1123.
• [27]Kleinjan M, van den Eijnden RJ, Engels RC: Adolescents' rationalizations to continue smoking: the role of disengagement beliefs and nicotine dependence in smoking cessation. Addict Behav 2009, 34:440-445.
• [28]Sutton S: Back to the drawing board? A review of applications of the transtheoretical model to substance use. Addiction 2001, 96:175-186.
• [29]Carlson LE, Taenzer P, Koopmans J, Casebeer A: Predictive value of aspects of the Transtheoretical Model on smoking cessation in a community-based, large-group cognitive behavioral program. Addict Behav 2003, 28:725-740.