Measurement invariance across administration mode: Examining the Posttraumatic Stress Disorder (PTSD) Checklist.

The Posttraumatic Stress Disorder (PTSD) Checklist (PCL) is commonly used to screen for PTSD in clinical and research contexts. While the PCL is utilized within numerous settings and populations, research has not yet established the extent to which individuals respond similarly across different modes of administration. The use of both telephone and web survey administration modes has numerous potential benefits, including data quality improvement, but may introduce an additional source of measurement error. The current study examined the psychometric properties, including factor structure and measurement invariance, of the PCL across telephone and web administration modes among 455 wounded, ill, or injured airmen who were medically retired or undergoing evaluation for disability caused by injuries and illnesses of a physical or psychological nature. Findings suggest the properties of the PCL were invariant with regard to the mode of administration, such that the overall scale structure and size of the loadings were similar across groups. Corrections were applied to the computation of probable PTSD diagnosis to account for partial scalar invariance. The lack of complete invariance did not affect probable PTSD diagnosis. Finally, differences in latent means across the telephone and web group were nonsignificant and modest in magnitude. These results indicate that although the PCL only achieved partial scalar invariance across administration modes, the practical impact of this difference on rates of probable PTSD is negligible. The practical benefits of administering the PCL over the telephone and on the web do not appear to be outweighed by the potential cost of additional measurement error. (PsycINFO Database Record

Text2Quit: an analysis of participant engagement in the mobile smoking cessation program.

BACKGROUND: Text2Quit, an interactive text-messaging program aimed at smoking cessation, has been shown to increase quit rates, but engagement has not been thoroughly explored. Understanding the program features associated with engagement and behavior change is integral for effective program design. OBJECTIVES: This study explored participants' interaction with the Text2Quit text-messaging program and associations between engagement and smoking cessation. METHODS: The study included the 262 participants who received the Text2Quit intervention. Self-reported engagement measures, primarily usage of Text2Quit keywords and survey responses, were collected through computer records of participant use. Demographic variables and self-reported smoking abstinence were recorded in surveys at baseline and 6-month assessment. RESULTS: The majority of participants (73%) maintained their subscription during the 6-month intervention. On average, participants received 210.51 text messages, 23.75 emails, and logged into the web portal 1.94 times. Being female was predictive of engagement with the program (ß = 15.39). Program engagement, measured by the keyword PLEDGE (p = .002) and the Smokefree Status at 7 Days survey (p < .001) were associated with 6-month abstinence; use of keywords SMOKED (p < .001), RELAPSE (p = .007), and STOP (p = .023) were inversely related to abstinence. While abstainers (N = 83, 31%) stayed enrolled longer and engaged with the program more frequently, program "dose" was not predictive of smoking cessation. CONCLUSIONS: Using interactive tools such as pledges and reporting on smoking status were predictive of cessation. Further study of program features is required to understand how to optimally design text messaging programs.

Combined Quitline Counseling and Text Messaging for Smoking Cessation: A Quasi-Experimental Evaluation.

INTRODUCTION: This study seeks to determine whether comprehensive quitline services combined with text messaging improve smoking cessation rates beyond those achieved by offering comprehensive quitline services alone. METHODS: The study sample consisted of callers to the Alere Wellbeing, Inc, commercial quitline in 2012. A quasi-experimental design was implemented using propensity score matching to create the intervention and control groups. The intervention group consisted of those who were offered and accepted a text message intervention in addition to usual quitline services, while the control group consisted of those who were not offered the text message intervention. Analyses utilized baseline data collected at intake, program use data (eg, call history and text message use), and reports of smoking behaviors and program satisfaction collected 6 months after intake. RESULTS: Similar rates of 7-day abstinence were reported regardless of whether participants received combined multi-call quitline services plus text messaging (25.3%) or multi-call quitline services in isolation (25.5%), though those who received combined services reported higher treatment satisfaction (P < .05). Among those who received combined services, the number of text messages sent to the text message program predicted 7-day abstinence such that those who sent more text messages were less likely to report 7-day abstinence. CONCLUSIONS: Text messaging may not confer additional benefits over and above those received through multi-modal, multi-call quitline programs. Future research should investigate whether text messaging programs improve quit rates when combined with less intensive services such as single-call phone counseling. IMPLICATIONS: While the impact of quitline and text messaging services for smoking cessation have been examined in isolation, no study has explored the impact of combined services on smoking outcomes. This study examines the role of text messaging in combination with comprehensive quitline services including multi-call phone counseling, access to an interactive website and nicotine replacement therapy.

Feasibility and Acceptability of a Text Messaging Program for Smoking Cessation in Israel.

Text messaging programs on mobile phones have been shown to promote smoking cessation. This study investigated whether a text-messaging program for smoking cessation, adapted from QuitNowTXT, is feasible in Israel and acceptable to Israeli smokers. Participants (N = 38) were given a baseline assessment, enrolled in the adapted text messaging program, and followed-up with at 2 weeks and 4 weeks after their quit date. The authors used an intent-to-treat analysis and found that 23.7% of participants reported having quit smoking at the 4-week follow-up. Participants sent an average of 12.9 text replies during the study period, and the majority reported reading most or all of the texts. However, 34.2% of participants had unsubscribed by the 4-week follow-up. Moderate levels of satisfaction were reported; more than half agreed that they would recommend the program. Suggestions for improvement included adding advice by an expert counselor, website support, and increased customization. Results indicate that a text messaging smoking cessation program developed by modifying the content of QuitNowTXT is feasible and could be acceptable to smokers in Israel. The experience adapting and pilot testing the program can serve as a model for using QuitNowTXT to develop and implement such programs in other countries.

Navigating the Road to Reintegration: Status and Continuing Support of the U.S. Air Force's Wounded Warriors.

The U.S. Air Force, wanting to gain greater insight into the well-being of its members who have sustained mental or physical injuries in combat or combat-related situations, including their quality of life and the challenges they will confront in their reintegration following separation or retirement, asked the RAND Corporation for assistance in gauging the current status of the Air Force's wounded warriors, including their use of and satisfaction with Air Force programs designed to serve them. This article presents the baseline findings from a longitudinal analysis of enrollees in the Air Force Wounded Warrior (AFW2) program who were receiving benefits or undergoing evaluation to receive benefits, the majority of whom had a primary administrative diagnosis of post-traumatic stress disorder (PTSD). A high proportion of the Airmen in the sample screened positive for PTSD (roughly 78 percent) and major depressive disorder (MDD) (roughly 75 percent); 69 percent screened positive for both. Although more than 90 percent of those in the sample who screened positive for PTSD or MDD were receiving treatment, about half indicated that there was at least one instance during the past year in which they desired mental health treatment but did not receive it. Participants reported concerns about stigma, confidentiality, and the quality of available treatment as barriers to receiving mental health care, though the current data do not link these concerns to a particular treatment setting. About 10 percent of Airmen reported a financial situation that could be considered as living in poverty based on U.S. Department of Health and Human Services' poverty guidelines. Similarly, close to 15 percent of those in the labor force could be considered unemployed. Reserve and National Guard Airmen evidenced heightened challenges across examined domains. Respondents were overall satisfied with the services they received from the AFW2 and Air Force Recovery Care Coordinator programs.

Barriers to compliance with Oregon batterer intervention program standards.

Although standards for batterer intervention programs (BIPs) have been adopted in nearly all U.S. states, there is no evidence that standards are implemented and no information about challenges programs may encounter in efforts to comply with standards. This study uses qualitative survey data from BIPs in the state of Oregon (N = 42) to identify barriers to implementation during a 2-year period following the introduction of state standards. Nine challenges were identified including difficulty finding qualified facilitators, inadequate funding, difficulty meeting training requirements, high workloads, trouble creating and maintaining collaborations, inability to accommodate diverse participant needs, conflict between state standards and county requirements, and perceived gaps between standards and evidence-based practices. These findings inform controversy surrounding BIP standards and efforts to increase BIP effectiveness.

A randomized trial of Text2Quit: a text messaging program for smoking cessation.

BACKGROUND: Text messaging programs on mobile phones have shown some promise in helping people quit smoking. Text2Quit is an automated, personalized, interactive mobile health program that sends text messages to offer advice, support, and reminders about quitting smoking. PURPOSE: To evaluate the effect of Text2Quit on biochemically confirmed repeated point prevalence abstinence in the context of an RCT conducted in the U.S. METHODS: Participants (n=503) were recruited on the Internet and randomized to receive Text2Quit or self-help material. Between 2011 and 2013, participants were surveyed at baseline and at 1, 3, and 6 months post-enrollment to assess smoking status. Saliva was collected from participants who reported not smoking in the past 7 days at the 6-month follow-up. An intent to treat analysis was used, and those lost to follow-up were categorized as smokers. All analyses were completed in 2013. RESULTS: Biochemically confirmed repeated point prevalence abstinence favored the intervention group, with 11.1% abstinent compared to 5.0% of the control group (relative risk=2.22, 95% CI=1.16, 4.26, p<0.05). Similarly, self-reported repeated point prevalence abstinence was higher in the intervention group (19.9%) than in the control group (10.0%) (p<0.01). Effects were found to be uniform across the analyzed demographic subgroups, although suggestive of a larger effect for non-whites than whites. CONCLUSIONS: These results provide initial support for the relative efficacy of the Text2Quit program.

The impact of legislative standards on batterer intervention program practices and characteristics.

Changes in social policy are often pursued with the goal of reducing a social problem by improving prevention efforts, intervention program practices, or participant outcomes. State legislative standards for intimate partner violence intervention programs have been adopted nearly universally across the US, however, we do not know whether such standards actually achieve the intended goal of affecting programs' policies and practices. To assess the effect that batterer intervention program (BIP) standards have on policies and practices of programs, this study used longitudinal surveys collected as part of an ongoing evaluation conducted from 2001 to the present to compare intervention program (N = 74) characteristics and practices at three time points before and after the adoption of standards in Oregon. Analyses were conducted to examine all BIPs in Oregon at each time point, as well as change among a subset of programs in existence at all survey assessments. Results indicate that across all programs, the use of mixed gender group co-facilitation increased by 14% between 2004 and 2008, while program length increased by approximately 12 weeks. However, other practices such as programs' coordination with community partners were unchanged. Analyses of within-program change revealed fewer differences, with only program length increasing significantly over the three assessments. These and other findings indicate that while standards affected program length as intended, other practices commonly addressed by legislative standards remained unchanged. The findings provide needed information regarding programs' compliance with components of the standards, the potential need for compliance monitoring, and the potential impact of state standards on program effectiveness and on the prevalence of intimate partner violence.