An expert system intervention for smoking cessation.

Intervention efficacy can be increased when the treatment is maximally matched to the needs of the client. One means of achieving such matching is through use of an expert system, a computer-based decision-making system designed to utilize client information to produce unique, matched information and interventions. An expert system can combine the individual matching possible in a clinic-based intervention and the low cost associated with a public health approach. This paper begins by discussing several alternative implementations of the expert system approach within the general context of communication theory. Second, the theoretical model and related empirical evidence which form the basis of the expert system is described briefly. Third, the details of a computer-driven, expert system intervention specifically developed for smoking cessation is described. Finally, empirical results from a study comparing the expert system intervention to three alternative interventions for smoking cessation are presented. In general, the expert system approach can provide a cost effective, viable, and efficacious means of intervening in a specific problem behavior area. Implications and potential areas of development are discussed.

[1]  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.

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

[3]  M. Fiore,et al.  The effectiveness of the nicotine patch for smoking cessation. A meta-analysis. , 1994, JAMA.

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

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

[6]  J. Prochaska,et al.  In Search of How People Change: Applications to Addictive Behaviors , 1992, The American psychologist.

[7]  J. Hollis,et al.  Take heart: results from the initial phase of a work-site wellness program. , 1995, American journal of public health.

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

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

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

[11]  W A Hunt,et al.  Relapse rates in addiction programs. , 1971, Journal of clinical psychology.

[12]  J. Hughes Combined psychological and nicotine gum treatment for smoking: a critical review. , 1991, Journal of substance abuse.

[13]  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.

[14]  J. Prochaska,et al.  Stages and processes of self-change of smoking: toward an integrative model of change. , 1983, Journal of consulting and clinical psychology.

[15]  W F Velicer,et al.  Applying the transtheoretical model to a representative sample of smokers. , 1995, Addictive behaviors.

[16]  K.,et al.  Work site smoking cessation: a meta-analysis of long-term quit rates from controlled studies. , 1990, Journal of occupational medicine. : official publication of the Industrial Medical Association.

[17]  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.

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

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

[20]  C. Perry,et al.  Community-wide prevention of cardiovascular disease: education strategies of the Minnesota Heart Health Program. , 1986, Preventive medicine.

[21]  J O Prochaska,et al.  Strong and weak principles for progressing from precontemplation to action on the basis of twelve problem behaviors. , 1994, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[22]  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.

[23]  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.

[24]  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.

[25]  W. Velicer,et al.  Understanding and intervening with the total population of smokers , 1993 .

[26]  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.

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