Motivational Interviewing Intervention With College Student Tobacco Users: Providers' Beliefs and Behaviors

Abstract

Objective: This study assessed college student health providers' use of Motivational Interviewing (MI) with tobacco users, as well as their beliefs about the use of brief interventions to help college student tobacco users quit. MI is recommended by the United States Public Health Service to increase tobacco users' willingness to quit. Participants: Participants included 83 clinicians from health clinics at 7 different universities in North Carolina. Methods: Paper-and-pencil baseline survey from a cluster randomized trial of college student health clinicians. Results: Twenty-two percent of respondents reported always or usually using MI during the past month for tobacco-using patients not ready to make a quit attempt. Student health providers also reported information with regards to their beliefs about tobacco cessation treatment, barriers to intervening with patients, and confidence in motivating students to consider quitting. Conclusions: Results highlight the need to encourage clinicians' use of motivationally focused interventions with student tobacco users.

Motivational Interviewing Intervention With College Student Tobacco Users: Providers' Beliefs and Behaviors

All authors

Robert S. McNamara PhD, Eunyoung Y. Song PhD, Beth A. Reboussin PhD, John Spangler MD, Jessica R. Pockey MPH, Caroline Kimes BS, Kristie L. Foley PhD & Erin L. Sutfin PhD

https://doi.org/10.1080/07448481.2014.1003376

Published online:

11 May 2015

TABLE 1. Providers' Beliefs About Patient Tobacco Intervention and Cessation (N = 83)

CSVDisplay Table

     

The Sexual Consent Scale–Revised: Development,Reliability, and Preliminary Validity

The Sexual Consent Scale–Revised (SCS–R) measures an individual's beliefs, attitudes, and behaviors with respect to how sexual consent should be and is negotiated between sexual partners. This study extends previous research on sexual consent by revising a scale using the Theory of Planned Behavior (Ajzen, 1991 Ajzen , I. ( 1991 ). The Theory of Planned Behavior . Organizational Behavior and Human Decision Processes , 50 , 179 – 211 .[Crossref], [Web of Science ®] , [Google Scholar], 2001 Ajzen , I. ( 2001 ). Attitudes . Annual Review of Psychology , 52 , 27 – 58 .[Crossref], [PubMed], [Web of Science ®] , [Google Scholar], 2005 Ajzen , I. ( 2005 ) . Attitudes, personality, and behavior ( , 2nd ed. ). Milton-Keynes , England : Open University Press/McGraw-Hill . [Google Scholar]) as its theoretical foundation. The psychometric properties of the SCS–R were established using factor analysis, construct validity tests, as well as internal consistency and test–retest reliability. Five factors emerged: perceived behavioral control, positive attitude toward establishing consent, sexual consent norms, indirect consent behaviors, and awareness of consent. Results indicated that the SCS–R can be useful for examining a variety of research questions relating to sexual consent.     

The Psychometric Properties of the Sexual Excitation/Sexual Inhibition Inventory for Women (SESII-W) Within a Dutch Population

According to the dual control model, sexual arousal is dependent on the disposition for both sexual excitation (SE) and sexual inhibition (SI; Bancroft, 1999 Bancroft , J. ( 1999 ). Central inhibition of sexual response in the male: A theoretical perspective . Neuroscience and Biobehavioral Reviews , 23 , 763 – 784 .[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]). Individual variability in sexual inhibition and sexual excitation could partly explain individual differences in sexual arousability and the likelihood of experiencing sexual problems (Bancroft, Graham, Janssen, &; Sanders, 2009 Bancroft , J. , Graham , C. A. , Janssen , E. , &; Sanders , S. A. ( 2009 ). The dual control model: Current status and future directions . Journal of Sex Research , 46 , 121 – 142 .[Taylor &; Francis Online], [Web of Science ®] , [Google Scholar]). The Sexual Excitation/Sexual Inhibition Inventory for Women (SESII-W) is a questionnaire developed to measure the factors sexual excitation and sexual inhibition (Graham, Sanders, &; Milhausen, 2006 Graham , C. A. , Sanders , S. A. , &; Milhausen , R. R. ( 2006 ). The Sexual Excitation/Sexual Inhibition Inventory for Women: Psychometric properties . Archives of Sexual Behavior , 35 , 397 – 409 .[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]). This study describes the validation of the Dutch version of the SESII-W in a sample of 445 women. Using confirmatory factor analysis, we determined that the eight lower-order factor model achieved adequate fit to the data. A decrement in fit was noted when the two higher-order factors SE and SI were included in the model. The measure demonstrated good construct validity, internal consistency, and test-retest reliability. Furthermore, the scores of women with sexual problems differed from those without sexual problems, providing evidence for the discriminant validity of the SESII-W.     

Reply to Cameron et al.: Mistakes Were Made. Can They Be Corrected?

Cameron, Cameron, and Proctor (2017 Cameron, P., Cameron, K. M., &; Proctor, K. (2017). Children of homosexuals more apt to become homosexual and experience parental molestation: Surveys over three decades. Marriage &; Family Review, 53, 429–433. doi:10.1080/01494929.2017.1279942[Taylor &; Francis Online] , [Google Scholar]) have complained that Cameron and Cameron (1996 Cameron, P., &; Cameron, K. (1996). Homosexual parents. Adolescence, 31, 757–776.[PubMed], [Web of Science ®] , [Google Scholar]) were not cited in some articles authored by this journal’s editor. As part of this editor’s policy of welcoming critiques of the editor or articles published in Marriage &; Family Review, we are pleased to respond, as part of an assignment for a graduate course in statistics and research design. Although remarkable for its time in terms of sample design, Cameron and Cameron’s (1996 Cameron, P., &; Cameron, K. (1996). Homosexual parents. Adolescence, 31, 757–776.[PubMed], [Web of Science ®] , [Google Scholar]) research featured substantial limitations or ambiguity in sampling attrition, measurement of parental sexual orientation, and small sample size with respect to the number of children with same-sex parents. Although we cannot recall the exact reasons for which the editor neglected to cite Cameron and Cameron (1996 Cameron, P., &; Cameron, K. (1996). Homosexual parents. Adolescence, 31, 757–776.[PubMed], [Web of Science ®] , [Google Scholar]) in more frequency or detail, there were many scientifically reasonable possibilities. Cameron et al. (2017 Cameron, P., Cameron, K. M., &; Proctor, K. (2017). Children of homosexuals more apt to become homosexual and experience parental molestation: Surveys over three decades. Marriage &; Family Review, 53, 429–433. doi:10.1080/01494929.2017.1279942[Taylor &; Francis Online] , [Google Scholar]) are welcome to respond in detail to our concerns.     

Response to Rosen et al. (2014) “Commentary on ‘Critical Flaws in the FSFI and IIEF’”

This is a response to the commentary by Rosen, Revicki, and Sand (2014 Rosen , R. C. , Revicki , D. A. , &; Sand , M. ( 2014 ). Commentary on “Critical flaws in the FSFI and the IIEF.” Journal of Sex Research , 51 , 492 – 497 . doi: 10.1080/00224499.2014.894491 [Taylor &; Francis Online], [Web of Science ®] , [Google Scholar]) on our original article titled “Critical Flaws in the Female Sexual Function Index and the International Index of Erectile Function” (Forbes, Baillie, &; Schniering, 2014 Forbes , M. K. , Baillie , A. J. , &; Schniering , C. A. ( 2014 ). Critical flaws in the Female Sexual Function Index and the International Index of Erectile Function . Journal of Sex Research , 51 , 485 – 491 . doi: 10.1080/00224499.2013.876607 [Taylor &; Francis Online], [Web of Science ®] , [Google Scholar]). We address his criticisms and clarify our points further using existing research. We conclude that there are a number of evident limitations to these popular measures, and suggest that researchers and clinicians familiarize themselves with the aim and scope of each measure before use.     

Factors Influencing University Students’ Explicit and Implicit Sexual Double Standards

Quantitative research has resulted in inconsistent evidence for the existence of a sexual double standard, leading Crawford and Popp (2003 Crawford , M. , &; Popp , D. ( 2003 ). Sexual double standards: A review and methodological critique of two decades of research . Journal of Sex Research , 40 , 13 – 26 .[Taylor &; Francis Online], [Web of Science ®] , [Google Scholar]) to issue a call for methodological innovation. The Implicit Association Test (IAT; Greenwald, McGhee, &; Schwartz, 1998 Greenwald , A. G. , McGhee , D. E. , &; Schwartz , J. L. K. ( 1998 ). Measuring individual differences in implicit cognition: The Implicit Association Test . Journal of Personality and Social Psychology , 74 , 1464 – 1480 .[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) is a measure that may provide a means to examine the double standard without the contamination of the demand characteristics and social desirability biases that plague self-report research (Marks &; Fraley, 2005 Marks , M. J. , &; Fraley , R. C. ( 2005 ). The sexual double standard: Fact or fiction? Sex Roles , 52 , 175 – 186 .[Crossref], [Web of Science ®] , [Google Scholar]). The purpose of this study was to examine the factors influencing explicit and implicit double standards, and to examine the relationship between these explicit and implicit double standards, and levels of socially desirable responding. One hundred and three university students completed a sexual double standard IAT, an explicit measure of the double standard, and measures of socially desirable responding. Hierarchical regression analysis indicated that levels of socially desirable responding were not related to implicit or explicit double standards. Men endorsed a stronger explicit traditional double standard than women, whereas for implicit sexual standards, men demonstrated a relatively gender-neutral evaluation and women demonstrated a strong reverse double standard. These results suggest the existence of a complex double standard, and indicate that more research of sexual attitudes should include implicit measures.     

Somebody's Fetish: Self-Objectification and Body Satisfaction Among Consensual Sadomasochists

Considering that sexuality scholars claim consensual sadomasochists experience sexual objectification differently from the general population (Califia, 1994 Califia, P. (1994). Public sex: The culture of radical sex. Pittsburgh, PA: Cleis Press. [Google Scholar]; Connell, 2002 Connell, R. W. (2002). Gender. Malden, MA: Blackwell. [Google Scholar]; Nussbaum, 1995 Nussbaum, M. C. (1995). Objectification. Philosophy and Public Affairs, 24(4), 249–291. doi:10.1111/j.1088-4963.1995.tb00032.x[Crossref], [Web of Science ®] , [Google Scholar]), this study explored self-objectification (Fredrickson &; Roberts, 1997 Fredrickson, B. L. &; Roberts, T. (1997). Objectification theory: Toward understanding women's lived experiences and mental health risks. Psychology of Women Quarterly, 21(2), 173–206. doi:10.1111/j.1471-6402.1997.tb00108.x[Crossref], [Web of Science ®] , [Google Scholar]) and body satisfaction among 121 self-identified consensual sadomasochists, 67 of whom also self-identified as women. Participants responded to an online survey and reported their self-objectification, self-surveillance, body shame, and body satisfaction measures, along with their body mass index (BMI) and identification as dominant, submissive, or switch. The data revealed that the study participants’ differed greatly in their sexual objectification experiences according to their genders, sexual orientations, and sadomasochistic identities, suggesting that consensual sadomasochism offers participants an environment partially free of the negative consequences resulting from Western beauty ideals.     

Children of Homosexuals More Apt to Become Homosexual and Experience Parental Molestation: Surveys Over Three Decades

In 1996 (Cameron &; Cameron), we reported that adult children of homosexuals more frequently reported homosexual desires and sex with their parent(s). Schumm (2015 Schumm, W. R. (2015). Sarantakos’s research on same-sex parenting in Australia and New Zealand: Importance, substance, and corroboration with research from the United States. Comprehensive Psychology, 4(16), 1–29. doi:10.2466/17.cp.4.16[Crossref] , [Google Scholar]) stated he would focus on “the multifaceted research of Sarantakos (1996 Cameron, P., &; Cameron, K. (1996). Homosexual parents. Adolescence, 31(124), 757–776.[PubMed] , [Google Scholar]) and any research that has corroborated his findings,” but neglected to include ours, though published contemporaneously with Sarantakos.     

Disability,pain and love in Jewish cosmology?

Individuals with disabilities face numerous barriers that limit their inclusion within the Jewish community (Trieschmann 2001 Trieschmann, R. B. 2001. “Spirituality and Energy Medicine.” Journal of Rehabilitation 67 (1): 26–32.[Web of Science ®] , [Google Scholar]). While many Jewish communities have progressed and moved towards an attitude of ‘acceptance’ and ‘tolerance’ for people with disabilities out of religious obligation, it is often a practice without the spiritual ethical governing force and guiding principles of respect, equality, and human rights (Shatz and Wolowelsky 2004 Shatz, D., and J. B. Wolowelsky. 2004. Mind, Body, and Judaism: The Interaction of Jewish Law with Psychology and Biology. Ktav Publishing House: Yeshiva University Press. [Google Scholar]). People with disabilities are stereotyped as dependent, draining, incompetent, pitiful, victims, freaks, angels, embarrassments, innocent, pathetic, and asexual social burdens (Nario-Redmond 2010 Nario-Redmond, M. R. 2010. “Cultural Stereotypes of Disabled and Non-Disabled Men and Women: Consensus for Global Category Representations and Diagnostic Domains.” British Journal of Social Psychology 49: 471–488.10.1348/014466609X468411 [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]). What is lacking is the consideration of people with disabilities as human beings. This injustice is most evident, painful, and damaging at an individual and communal level when it comes to Jewish singles and their pursuit of intimate relationships. A central Jewish value, right, and goal, one that is strongly promoted in Israeli society, is that of committed intimate relationships. However, this value does not apply to people with disabilities     

Historical Periodicals in the College Libraries of Pennsylvania

The author reports findings from a study that explored the methods a U.S. history teacher used to promote students' higher order thinking and engagement. The teacher, Mr. Scott (a pseudonym), challenged his urban high school students to develop stronger understandings of history by enacting elements of the teaching for understanding (TFU) curricular framework (Perkins and Blythe 1994 Perkins, D. and Blythe, T. 1994. Putting understanding up front. Educational Leadership, 51(5): 4–7. [Web of Science ®] , [Google Scholar]; Wiske 1998). This article describes how the teacher shared his learning goals with students, created interesting and engaging central questions and culminating group projects, and assessed students' performances. The findings illustrate the power of linking curricular frameworks such as TFU to practice and provide a model of what is possible (Shulman 1987 Shulman, L. S. 1987. Knowledge and teaching: Foundations of the new reform. Harvard Educational Review, 57(1): 1–22. [Crossref], [Web of Science ®] , [Google Scholar]) for practicing teachers.     

Sexual Esteem in Emerging Adulthood: Associations with Sexual Behavior,Contraception Use,and Romantic Relationships

Sexual esteem is an integral psychological aspect of sexual health (Snell &; Papini, 1989 Snell, W. E. Jr., &; Papini, D. R. (1989). The Sexuality Scale: An instrument to measure sexual‐esteem, sexual‐depression, and sexual‐preoccupation. Journal of Sex Research, 26, 256–263. doi:10.1080/00224498909551510[Taylor &; Francis Online], [Web of Science ®] , [Google Scholar]), yet it is unclear whether sexual esteem is associated with sexual health behavior among heterosexual men and women. The current analysis used a normative framework for sexual development (Lefkowitz &; Gillen, 2006 Lefkowitz, E. S., &; Gillen, M. M. (2006). “Sex is just a normal part of life”: Sexuality in emerging adulthood. In J. J. Arnett &; J. L. Tanner (Eds.), Emerging adults in America: Coming of age in the 21st century (pp. 235–256). Washington, DC: American Psychological Association.[Crossref] , [Google Scholar]; Tolman &; McClelland, 2011 Tolman, D. L., &; McClelland, S. I. (2011). Normative sexuality development in adolescence: A decade in review, 2000–2009. Journal of Research on Adolescence, 21, 242–255. doi:10.1111/j.1532-7795.2010.00726.x[Crossref], [Web of Science ®] , [Google Scholar]) by examining the association of sexual esteem with sexual behavior, contraception use, and romantic relationship characteristics. Participants (N = 518; 56.0% female; mean age = 20.43 years; 26.8% identified as Hispanic/Latino; among non-Hispanic/Latinos, 27.2% of the full sample identified as European American, 22.4% Asian American, 14.9% African American, and 8.7% multiracial) completed Web-based surveys at a large Northeastern university. Participants who had oral sex more frequently, recently had more oral and penetrative sex partners (particularly for male participants), and spent more college semesters in romantic relationships tended to have higher sexual esteem than those who had sex less frequently, with fewer partners, or spent more semesters without romantic partners. Sexually active male emerging adults who never used contraception during recent penetrative sex tended to have higher sexual esteem than those who did use it, whereas female emerging adults who never used contraception tended to have lower sexual esteem than those who did use it. Implications of these results for the development of a healthy sexual self-concept in emerging adulthood are discussed.     

Critical Flaws in the Female Sexual Function Index and the International Index of Erectile Function

The Female Sexual Function Index (FSFI; Rosen et al., 2000 Rosen , R. C. , Brown , C. , Heiman , J. , Leiblum , S. , Meston , C. , Shabsigh , R. , … D'Agostino , R. ( 2000 ). The Female Sexual Function Index (FSFI): A multidimensional self-report instrument for the assessment of female sexual function . Journal of Sex and Marital Therapy , 26 , 191 – 208 . doi: 10.1080/009262300278597 [Taylor &; Francis Online], [Web of Science ®] , [Google Scholar]) and International Index of Erectile Function (IIEF; Rosen et al., 1997 Rosen , R. C. , Riley , A. , Wagner , G. , Osterloh , I. H. , Kirkpatrick , J. , &; Mishra , A. ( 1997 ). The International Index of Erectile Dysfunction (IIEF): A multidimensional scale for assessment of erectile dysfunction . Urology , 49 , 822 – 830 . doi: 10.1016/S0090-4295(97)00238-0 [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) are two of the most widely used measures of sexual dysfunction. However, they have potential measurement and psychometric flaws that have not been addressed in the literature. This article examines the measurement capabilities of these measures based on data collected from an online study in 2010. A convenience sample of 518 sexually active adults (65% female) drawn from the general community were included in the analyses. Both measures displayed critical theoretical and measurement problems for the assessment of sexual problems beyond sexual arousal, and for the sexual desire domains in particular. Based on these results, we encourage clinicians and researchers to think critically about whether the FSFI and IIEF are appropriate measures for their practice and research. In particular, these measures are inappropriate for use among individuals who are not currently sexually active, and research with a focus other than sexual arousal should consider supplementary measures of sexual function. The psychometric properties of these measures should be reassessed in clinical samples, but the theoretical issues with the measures raised in this article are relevant across clinical and research contexts.     

The Effects of Importance of Religion and Church Attendance on Adolescents' Moral Beliefs

Drawing on the work of Emile Durkheim ([1912] 1995) and Rodney Stark (2001 Stark, Rodney. 2001. Gods, Rituals, and the Moral Order. Journal for the Scientific Study of Religion, 40(4): 619–636. [Crossref], [Web of Science ®] , [Google Scholar]) as well as research on the anti-ascetic thesis and reference group theory, we formulate a series of hypotheses regarding the effects of church attendance and importance of religion on adolescents' moral beliefs about marijuana use, getting drunk, hitting, and property offenses. The results of our study suggest that moral beliefs are more consistently and strongly related to importance of religion than to church attendance. Furthermore, much of the effect of church attendance on moral beliefs is mediated by importance of religion. Finally, we find evidence that importance of religion moderates (interaction) the effect of church attendance on moral beliefs. When adolescents believe religion is important, frequent church attendance further strengthens their moral beliefs. On the other hand, when adolescents believe religion is not important, frequent church attendance may actually reduce moral beliefs.     

Consensual Nonmonogamy: Psychological Well-Being and Relationship Quality Correlates

Consensually nonmonogamous relationships are those in which all partners explicitly agree that each partner may have romantic or sexual relationships with others (Conley, Ziegler, Moors, Matsick, &; Valentine, 2013 Conley, T. D., Ziegler, A., Moors, A. C., Matsick, J. L., &; Valentine, B. (2013). A critical examination of popular assumptions about the benefits and outcomes of monogamous relationships. Personality and Social Psychology Review, 17, 124–141. doi:10.1177/1088868312467087[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]). In this article, research examining the associations between consensual nonmonogamy, psychological well-being, and relationship quality is reviewed. Specifically, three types of consensual nonmonogamy are examined: swinging, open relationships (including sexually open marriage and gay open relationships), and polyamory. Swinging refers to when a couple practices extradyadic sex with members of another couple; open relationships are relationships in which partners agree that they can have extradyadic sex; and polyamory is the practice of, belief in, or willingness to engage in consensual nonmonogamy, typically in long-term and/or loving relationships. General trends in the research reviewed suggest that consensual nonmonogamists have similar psychological well-being and relationship quality as monogamists. Methodological challenges in research on consensual nonmonogamy and directions for future research are discussed.