Effects of frequency and duration in telephone counselling for smoking cessation.

OBJECTIVE: This study evaluates alternative protocols in telephone counselling for smoking cessation. DESIGN: The American Cancer Society enrolled 6322 clients in a randomised trial comparing three counselling formats of varying duration and frequency of contact, with or without booster sessions, and mailed self help booklets without telephone counselling. SETTING AND PARTICIPANTS: Participants were drawn from callers to the American Cancer Society's National Cancer Information Center seeking assistance with smoking cessation who provided informed consent and were adult daily smokers, ready to make a quit attempt within two weeks, and from states not served by an evidence based proactive telephone counselling programme. OUTCOMES: Six-month cessation rates (30-day point prevalence) were measured in telephone interviews. RESULTS: There was a significant counselling effect. The overall cessation rates that were yielded by a brief protocol including booster sessions were equivalent to those obtained with the American Cancer Society's standard protocol with boosters. CONCLUSIONS: Based on these findings, the abbreviated protocol with five sessions and two boosters is considered to be an option for improving cost efficiency in the delivery of this service.

The relationship between psychosocial factors and condom use among African-American adolescents.

The present investigation explored the relationship between psychosocial factors and condom use by African-American adolescents. Two hundred twenty-nine males, aged 14 to 19 years, responded to a health behavior survey that gathered information on demographics, HIV knowledge, perceived certainty of future condom use, present and past use of condoms, and intention to use condoms in the next six months. Several psychological variables, including sexual self-efficacy and self-esteem, were also measured. It was found that the majority of participants were sexually active by age 13, had four or more lifetime sexual partners, and were using condoms regularly. Multiple linear regression analysis indicated that sexual self-efficacy predicted perceived certainty of condom use. In addition, self-esteem and sexual self-efficacy predicted intention to use condoms. These findings highlight the need to develop HIV prevention curricula for African-American male adolescents that not only emphasize the potential risks associated with having multiple sexual partners, but also include components to enhance self-worth and sexual self-efficacy.

Psychosocial determinants of the onset and escalation of smoking: cross-sectional and prospective findings in multiethnic middle school samples.

PURPOSE: To investigate a broad range of social influence-related and global determinants of smoking to aid in the design of comprehensive multiethnic interventions by testing the most important factors of initiation and escalation of smoking across various subgroups. METHODS: Cross-sectional (N = 2546) and cohort (N = 736) samples of multiethnic middle school students near a large Southwestern metropolis were surveyed through self-report questionnaires. The confidential questionnaires included information on demographics, risk factors, and smoking behavior and were administered in class by trained data collectors. Multivariable logistic regression analysis was used to examine the statistical significance and strength of the factors. RESULTS: Those lower in self-esteem and higher in social assertiveness appeared to be most at risk for the onset of smoking, whereas those low in optimism appeared to be the most at risk for the escalation of smoking. Attitudes, friends' norms, parents' norms, perceived behavioral control, and perceived prevalence were consistent predictors of all smoking status outcomes. CONCLUSIONS: The behavioral-specific determinants of smoking appear to be important predictors of smoking status outcomes in all demographic subgroups. The relationships of the global determinants were more dependent on the smoking outcome variable and subgroup examined. The findings may serve to help facilitate the targeting of comprehensive interventions aimed at reducing adolescent smoking in multiethnic and ethnic group-specific populations.