Multiple risk expert systems interventions: impact of simultaneous stage-matched expert system interventions for smoking, high-fat diet, and sun exposure in a population of parents.

Three stage-based expert system interventions for smoking, high-fat diet, and unsafe sun exposure were evaluated in a sample of 2,460 parents of teenagers. Eighty-four percent of the eligible parents were enrolled in a 2-arm randomized control trial, with the treatment group receiving individualized feedback reports for each of their relevant behaviors at 0, 6, and 12 months as well as a multiple behavior manual. At 24 months, the expert system outperformed the comparison condition across all 3 risk behaviors, resulting in 22% of the participants in action or maintenance for smoking (vs. 16% for the comparison condition), 34% for diet (vs. 26%), and 30% for sun exposure (vs. 22%). Proactive, home-based, and stage-matched expert systems can produce significant multiple behavior changes in at-risk populations where the majority of participants are not prepared to change.

[1]  Patricio Cumsille,et al.  Methods for Handling Missing Data , 2003 .

[2]  W. Rakowski,et al.  Stages of change and decisional balance for 12 problem behaviors. , 1994, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[3]  W. Velicer,et al.  Interactive versus noninteractive interventions and dose-response relationships for stage-matched smoking cessation programs in a managed care setting. , 1999, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[4]  A. Avenell,et al.  Systematic review of randomised controlled trials , 2018 .

[5]  M. Mittelmark,et al.  Changes in adult cigarette smoking in the Minnesota Heart Health Program. , 1995, American journal of public health.

[6]  M. Kreuter,et al.  Evaluating Community-Based Collaborative Mechanisms: Implications for Practitioners , 2000 .

[7]  W F Velicer,et al.  Assessing outcome in smoking cessation studies. , 1992, Psychological bulletin.

[8]  W F Velicer,et al.  Counselor and stimulus control enhancements of a stage-matched expert system intervention for smokers in a managed care setting. , 2001, Preventive medicine.

[9]  W F Velicer,et al.  Standardized, individualized, interactive, and personalized self-help programs for smoking cessation. , 1993, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[10]  W F Velicer,et al.  Measuring processes of change: applications to the cessation of smoking. , 1988, Journal of consulting and clinical psychology.

[11]  M. Weinstock,et al.  Randomized controlled community trial of the efficacy of a multicomponent stage-matched intervention to increase sun protection among beachgoers. , 2002, Preventive medicine.

[12]  J. L. Schwartz Review and evaluation of smoking cessation methods : the United States and Canada, 1978-1985 , 1987 .

[13]  V. Strecher,et al.  One size does not fit all: The case for tailoring print materials , 1999, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[14]  S. Curry,et al.  Self-help interventions for smoking cessation. , 1993, Journal of consulting and clinical psychology.

[15]  P. Greenwald,et al.  The new emphasis in cancer control. , 1985, Journal of the National Cancer Institute.

[16]  Mitchell H. Gail,et al.  Community Intervention Trial for Smoking Cessation (COMMIT): I. cohort results from a four-year community intervention. , 1995, American journal of public health.

[17]  J. Schafer,et al.  Missing data: our view of the state of the art. , 2002, Psychological methods.

[18]  W F Velicer,et al.  Relapse situations and self-efficacy: an integrative model. , 1990, Addictive behaviors.

[19]  Diane C. Thompson,et al.  The validity of self-reported smoking: a review and meta-analysis. , 1994, American journal of public health.

[20]  W F Velicer,et al.  Decisional balance measure for assessing and predicting smoking status. , 1985, Journal of personality and social psychology.

[21]  Mc Fiore,et al.  Treating Tobacco Use and Dependence , 2000 .

[22]  W F Velicer,et al.  Evaluating a population-based recruitment approach and a stage-based expert system intervention for smoking cessation. , 2001, Addictive behaviors.

[23]  J. Hollis,et al.  Biochemical validation of smoking status: pros, cons, and data from four low-intensity intervention trials. , 1993, Addictive behaviors.

[24]  A. Folsom,et al.  Community education for cardiovascular disease prevention: risk factor changes in the Minnesota Heart Health Program. , 1994, American journal of public health.

[25]  G. R. Reed,et al.  Stages of change for reducing dietary fat to 30% of energy or less. , 1994, Journal of the American Dietetic Association.

[26]  D. Hedeker,et al.  Statistical analysis of randomized trials in tobacco treatment: longitudinal designs with dichotomous outcome. , 2001, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[27]  S. Fortmann,et al.  Changes in adult cigarette smoking prevalence after 5 years of community health education: the Stanford Five-City Project. , 1993, American journal of epidemiology.

[28]  Joseph L Schafer,et al.  Analysis of Incomplete Multivariate Data , 1997 .

[29]  W F Velicer,et al.  An expert system intervention for smoking cessation. , 1993, Patient education and counseling.

[30]  W L Haskell,et al.  Effects of communitywide education on cardiovascular disease risk factors. The Stanford Five-City Project. , 1990, JAMA.

[31]  Wayne F Velicer,et al.  A comparison of four self-report smoking cessation outcome measures. , 2004, Addictive behaviors.

[32]  E Lichtenstein,et al.  Smoking cessation: what have we learned over the past decade? , 1992, Journal of consulting and clinical psychology.

[33]  M. Gail,et al.  Community intervention trial for smoking cessation (COMMIT): II. Changes in adult cigarette smoking prevalence. , 1995, American journal of public health.

[34]  W F Velicer,et al.  Distribution of smokers by stage in three representative samples. , 1995, Preventive medicine.

[35]  W. Velicer,et al.  Biochemical verification of tobacco use and cessation. , 2002, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[36]  Abraham Wandersman,et al.  Community interventions and effective prevention. , 2003, The American psychologist.

[37]  W F Velicer,et al.  The process of smoking cessation: an analysis of precontemplation, contemplation, and preparation stages of change. , 1991, Journal of consulting and clinical psychology.

[38]  J. Hardin,et al.  Generalized Estimating Equations , 2002 .

[39]  V. Strecher Computer-tailored smoking cessation materials: a review and discussion. , 1999, Patient education and counseling.

[40]  B. Flay Efficacy and effectiveness trials (and other phases of research) in the development of health promotion programs. , 1986, Preventive medicine.

[41]  R. Carleton,et al.  The Pawtucket Heart Health Program: community changes in cardiovascular risk factors and projected disease risk. , 1995, American journal of public health.

[42]  K Y Liang,et al.  Longitudinal data analysis for discrete and continuous outcomes. , 1986, Biometrics.

[43]  M. Weinstock,et al.  Sun protection behaviors and stages of change for the primary prevention of skin cancers among beachgoers in Southeastern New England , 2000, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.