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

     

Perceptions and Use of Gerotechnology: Implications for Aging in Place

ABSTRACT

Understanding perceptions and use of gerotechnology is crucial to optimize design, application, and education strategies that may reduce caregiver burden, extend healthy aging in place, and minimize demands on the health care system. A pilot project was conducted to explore attitudes, opinions, and preferences of older adults concerning the use of technology to support and extend their ability to “aging in place.” Four major themes emerged as important for older adults to age in place: safety and independence, social interaction, use of technology in the past, and the desire for support. Based on the literature in gerotechnology and the pilot study findings, we present a conceptual model that integrates gerotechnology into the life span theory of control (Heckhausen & Schulz, 1995 Heckhausen, J. and Schulz, R. 1995. A life-span theory of control. Psychological Review, 102(2): 284–304. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]; Schulz & Heckhausen, 1996 Schulz, R. and Heckhausen, J. 1996. A life span model of successful aging. American Psychologist, 51(7): 702–714. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) and the concept of aging in place.     

Religiosity as a Potential Moderator of the Effects of R-rated Movies on Delinquency

Previous research suggests viewing R-rated movies is associated with delinquency (Tanski et al. 2010 Tanski , Susanne E. , Sonya Dal Cin , Mike Stoolmiller , and James D. Sargent . 2010. “Parental R-Rated Movie Restriction and Early-Onset Alcohol Use.” Journal of Studies on Alcohol and Drugs 71(3):452–460.[PubMed], [Web of Science ®] , [Google Scholar]; Titus-Ernstoff et al. 2008 Titus-Ernstoff , L. , M. A. Dalton , A. M. Adachi-Mejia , M. R. Longacre , and M. L. Beach . 2008 . “Longitudinal Study of Viewing Smoking in Movies and Initiation of Smoking by Children.” Pediatrics 121 : 15 – 21 .[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]), while religiosity leads to decreases in substance use (Jang and Johnson 2001 Jang , Sung Joon and Byron R. Johnson . 2001 . “Neighborhood Disorder, Individual Religiosity, and Adolescent Use of Illicit Drugs: A Test of Multilevel Hypotheses.” Criminology 39 ( 1 ): 109 – 144 .[Crossref], [Web of Science ®] , [Google Scholar]; Kovacs, Piko, and Fitzpatrick 2011 Jang , Sung Joon and Byron R. Johnson . 2011 . “The Effects of Childhood Exposure to Drug Users and Religion on Drug Use in Adolescence and Young Adulthood.” Youth and Society 43 : 1220 – 1245 .[Crossref], [Web of Science ®] , [Google Scholar]; Miller 1998 Miller , W. 1998 . “Researching the Spiritual Dimensions of Alcohol and Other Drug Problems.” Addiction 93 : 979 – 990 .[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]; Regnerus 2003 Regnerus , Mark D. 2003 . “Moral Communities and Adolescent Delinquency: Religious Contexts and Community Social Control.” Sociological Quarterly 44 : 523 – 554 .[Crossref], [Web of Science ®] , [Google Scholar]). However, the influences of religiosity and viewing R-rated movies have not been examined in conjunction. This article tests whether religiosity moderates the effects of R-rated movies on delinquency, results suggesting that rather than religiosity moderating the effects of R-rated movies on delinquency, viewing R-rated movies actually tempers the pro-social effects of religiosity. This finding only held true for certain types of substance abuse, and not activity-based forms of delinquency such as fighting. The results are discussed in light of their implications for the current study of the effects of religiosity on delinquency, and suggestions are made for future research on the relationship between viewing R-rated movies and delinquency.     

Unreasonable adjustments: the additional unpaid labour of academics with disabilities

Abstract

Two recent contributions to this section have drawn attention to the barriers which academics with disabilities have to navigate in academia where ableism “is endemic” (Brown and Leigh, 2018 Brown, N & Leigh, J (2018) Abelism in academia? Where are the disabled and ill academics. Disability & Society, 33 (6): 985–989.[Taylor & Francis Online], [Web of Science ®] , [Google Scholar]: 4). Hannam-Swain (2018 Hannam-Swain, S (2018) The additional labour of a disabled PhD student. Disability & Society, 33 (1): 138–142.[Taylor & Francis Online], [Web of Science ®] , [Google Scholar]) highlighted the additional intellectual, emotional and physical labour required of her as a disabled PhD student, and Brown and Leigh (2018 Brown, N & Leigh, J (2018) Abelism in academia? Where are the disabled and ill academics. Disability & Society, 33 (6): 985–989.[Taylor & Francis Online], [Web of Science ®] , [Google Scholar]) queried “where are all the disabled and ill academics?” However, Brown and Leigh primarily focus on those with invisible “conditions” and the dilemmas raised by disclosure in a context where such conditions negate academic status and credibility. In contrast, since my “disability” is visible, I do not share the dilemma/“luxury” of secrecy. My presence announces my status before me, and this negates my personhood altogether in academic settings. It also places a burden of additional unpaid labour upon me which has significant mental health and career impacts as well as violating principles of equality.     

What do young adult carers learn through supporting family members? Extending the affirmation model

Abstract

Some writers (e.g. O'Dell, Crafter, de Abreu, Cline 2010 O’Dell, Lindsey, Sarah Crafter, Guida de Abreu, and Tony Cline. 2010. Constructing ‘Normal Childhoods’: Young People Talk About Young Carers. Disability & Society, 25 (6): 643–655.[Taylor & Francis Online], [Web of Science ®] , [Google Scholar]) have argued that young carers are just one among many categories of youth who navigate the transition to adulthood while already carrying responsibilities usually associated with adulthood. This article explores that position in relation to a research project, undertaken in North-East England, which generated 13 in-depth biographical accounts with 16–25-year-old carers about their transitions to adulthood. It will be argued that their experiences of supporting disabled people in their families resulted in these young adult carers becoming more other-centred than their peers. Otherwise, their transitions to adulthood were mostly typical of young people in other types of adult role. The article discusses whether an affirmation model of disability (Swain and French 2000 Swain, John and Sally French. 2000. Towards an Affirmation Model of Disability. Disability & Society, 15 (4): 569–582.[Taylor & Francis Online], [Web of Science ®] , [Google Scholar]) can be used to help young adult carers take positive ownership of their identities in the challenging context of post-industrial youth.     

The Dangers of the Universal: A Critique of Fonagy and Target's Theory of Sexual Enjoyment

Despite the cultural specificity of aspects of attachment theory (Layton, 2006 Layton , L. ( 2006 ). Racial identities, racial enactments, and normative unconscious processes . Psychoanalytic Quarterly , 75 , 237 – 269 .[Taylor & Francis Online], [Web of Science ®] , [Google Scholar]) it remains influential. Disorganized attachment and the alien self are linked to borderline phenomena and attacks upon the body (Fonagy et al., 2002 Fonagy , P. , Gergely , G. , Jurist , E. , & Target , M. ( 2002 ). Affect Regulation, Mentalization and the Development of the Self . New York , NY : Other Press . [Google Scholar]), including sexual attacks (Straker, 2002 Straker , G. ( 2002 ). Being in two minds: The psychodynamics of paedophilia. In Australian Psychoanalytic Society annual conference, July, Melbourne, Australia . [Google Scholar]). Recently (Fonagy, 2006 Fonagy , P. ( 2006 ). Psychosexuality and psychoanalysis: An overview . In: Identity, Gender and Sexuality 150 Years After Freud , ed. P. Fonagy , R. Krause , & M. Leuzinger-Bohleber . London , UK : International Psychoanalytical Association , pp. 1 – 20 . [Google Scholar], 2008 ——— . ( 2008 ). A genuinely developmental theory of sexual enjoyment and its implications for psychoanalytic technique . Journal of the American Psychoanalytic Association , 56 , 11 – 36 .[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]; Target, 2007 Target , M. ( 2007 ). Is our sexuality our own? A developmental model of sexuality based on early affect mirroring . British Journal of Psychotherapy , 23 , 517 – 530 .[Crossref] , [Google Scholar]) used the concept of the alien self to explain sexuality in general. This article challenges this extension as it again ignores cultural specificity, presents psychoanalysis as the arbiter of “normal” sexuality, and entrenches heteronormativity. It also lends itself to inadvertently condoning sexual harassment, as evidenced in a case study presented by Fonagy (2008 ——— . ( 2008 ). A genuinely developmental theory of sexual enjoyment and its implications for psychoanalytic technique . Journal of the American Psychoanalytic Association , 56 , 11 – 36 .[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]).     

Institutional processes of organizational culture

Queries into the creation of collective meaning through social processes arise in both organization culture and institutional theory. This paper applies DiMaggio and Powell’s (1983 DiMaggio, P.J. and Powell, W.W. 1983. The iron cage revisited: Institutional isomorphism and collective rationality in organizational fields. American Sociological Review, 48: 147–60. [Crossref], [Web of Science ®] , [Google Scholar]) three isomorphic processes (mimetic, normative and coercive) from institutional theory to re‐think how structural and dynamic aspects of culture become nested, taken‐for‐granted and transmitted. We consider both acquiescence and resistance to isomorphic pressures in an effort to understand cultural persistence and transmission, forms of resistance to culture, change, the role of sub‐cultures and power usage through Oliver’s (1992 Oliver, C. 1992. The antecedents of de‐institutionalization. Organization Studies, 13: 563–88. [Crossref], [Web of Science ®] , [Google Scholar]) de‐institutionalization thesis. Our purpose in applying isomorphic processes to organizational culture is to offer another layer of understanding enhanced by the growing body of research in institutional theory, bridge one division between micro and macro theory and provide some suggestions for future research.     

Clinical Realism Versus the Seductions of Universal Theory: Discussion of Celenza's “The Guilty Pleasure of Erotic Countertransference: Searching for Radial True”

In this discussion of Celenza's (this issue) article, I consider a paradox in our responses to psychoanalytic writing: from the same data, we expect both “clinical realism” and something more universal that expands psychoanalytic theory. So with Celenza's rich clinical material: from it, I argue, we may be able to make some universal claims about psychoanalytic process at the most general level. It is not, however, possible to make universal claims about what transpires in analyses in general based on the particular treatments she describes. Instead, I argue that the content of any given analysis inevitably varies with each individual patient and each analytic dyad. This discussion is greatly informed by the work of Edgar Levenson (1982 Levenson , E. ( 1982 ). Follow the fox: An inquiry into the vicissitudes of psychoanalytic supervision . Contemporary Psychoanalysis , 18 , 1 – 15 .[Taylor & Francis Online], [Web of Science ®] , [Google Scholar]) and Benjamin Wolstein (1981 ———. ( 1981 ). Psychic realism of psychoanalytic inquiry . Contemporary Psychoanalysis , 17 , 399 – 412 .[Taylor & Francis Online], [Web of Science ®] , [Google Scholar]).     

Can the Earned Income Tax Credit Increase the Number of Unmarried Black Parent Families?

Since the 1960s an increasing number of Black children are reared by poor unmarried parents on welfare. To reduce poverty, minimize welfare dependence, and provide a monetary incentive for low-income, unmarried parents to wed, the government established the earned income tax credit (EITC). Since its establishment in 1975, however, scholars know very little about whether this credit can increase Black marriage among low-income couples with children. To address this paucity, I support and extend Mayhew's (1980 Mayhew , B. H. ( 1980 ). Structuralism versus individualism: Part I, Shadowboxing in the dark . Social Forces , 59 , 335 – 375 .[Crossref], [Web of Science ®] , [Google Scholar], 1981 Mayhew , B. H. ( 1981 ). Structuralism versus individualism: Part II, Ideological and other obfuscations . Social Forces , 59 , 627 – 648 .[Crossref], [Web of Science ®] , [Google Scholar]) micro-sociological and macro-sociological perspectives by highlighting the individual, interpersonal, and sociological factors that encourage or discourage Black marriage. I examined the qualitative responses of 17 Blacks between the ages of 23 and 61 years regarding whether they believed an increased child dependent tax credit (limited to married parents) would increase the number of married parent Black families. Qualitative analyses of the data revealed that although some participants were hopeful that the EITC could increase the number of Black marriages, most did not believe the EITC would substantially increase the number of Black marriages because the credit fails to address the intrinsic value of marriage. Supporting qualitative data are presented in connection with each theme. Practical and policy implications for Black marriage are also discussed.     

Stepfamilies and the Law: Legal Ambiguities and Suggestions for Reform

Cherlin's (1978 Cherlin, A. 1978. Remarriage as an incomplete institution. American Journal of Sociology, 84: 634–650. [Crossref], [Web of Science ®] , [Google Scholar]) argument that stepfamilies are incomplete as far as the legal system is concerned is still valid and relevant today. This review of literature discusses the ambiguous role stepparents have in the legal system, both in intact and divorced stepfamilies. Legal scholars and social science researchers' suggestions to help stepfamilies find their place within the legal system are also included to show the variation of the proposed solutions. Scholars seem uncertain as to how to accomplish the task of changing laws to benefit stepfamilies, but agree that laws need to give more authority and recognition to the stepparent role.     

Thinking the Unthinkable: Anal Sex in Theory and Practice

This essay takes up the issue of anal sexuality among gay men in order to consider the relationship between bodily and psychic penetrability. The lack of recognition some gay men may experience with this aspect of their sexuality suggests the importance that feeling “mentalized” (e.g., Fonagy and Target, 1993 Fonagy , P. & Target , M. ( 1993 ). Aggression and the psychological self . International Journal of Psycho-Analysis , 74 , 471 – 485 .[PubMed], [Web of Science ®] , [Google Scholar]) may play in adult life. Drawing on early gay liberation and ACT UP-era theorizing about anal sex and an extended clinical example, I explore the meanings of gay men's wishes to (and fears of) penetrate and be penetrated on both bodily and psychic levels as well as the consequences of feeling denied entry. My consideration of these matters becomes in turn an occasion for a critical assessment of the mentalization concept itself.     

The Influence of Gender Role Attitudes on Perceptions of Women's Work Performance and the Importance of Fair Pay

Gender role attitudes and their influence on perceptions of male and female work performance are important aspects understanding workplace gender inequality. Reskin (2000 Reskin , B. 2000 . “Proximate Causes of Employment Discrimination.” Contemporary Sociology 29 ( 2 ): 319 – 328 .[Crossref], [Web of Science ®] , [Google Scholar]) suggests researchers must look to non-conscious causes in order to understand and alleviate gender inequality in the workplace. Also critical to understanding workplace gender inequality is the differential importance placed on being paid fairly. Using a survey sample of 525 traditional undergraduate students from a public university in the middle south of the United States consisting of approximately one-third African Americans and two-thirds whites, race and sex differences are examined. The more liberal the respondent in terms of gender roles, the less they perceived performance inferiority of females. Excluding white males, those more liberal on gender roles perceived fair pay as more important. Gender differences are stronger among whites. Implications for the gender inequities at work are discussed.     

MISSED CALL? A REEXAMINATION OF SPORT FANS' AND NONFANS' ALCOHOL USAGE AND ALCOHOL-RELATED EXPERIENCES

The current investigation attempted to replicate and extend Nelson and Weschler's (2003 Nelson , T. F. and H. Wechsler . 2003 . “School Spirits: Alcohol and Collegiate Sport Fans.” Addictive Behaviors 28 : 1 – 11 .[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) research that indicated that college student sport fans were more likely to report problematic alcohol usage and more negative alcohol-related experiences in comparison to nonfans. In addition to utilizing the original study's operational definition of fan (spectator-based), 323 college students were categorized according to more traditional measures of fandom, specifically levels of fan and team identification. Contrary to the previous research, the results indicated that fans' and nonfans' alcohol usage and experiences of negative alcohol-related events were not significantly different. Additionally, both forms of identification (fan and team) failed to predict problematic alcohol usage and negative alcohol-related experiences. Although the results were unaffected by the operational definitions of fan, distinguishing certain subgroups of fans may be important in regards to clarifying and advancing our understanding of the potential relationship between sport and alcohol usage. These distinctions could guide efforts to reduce problematic alcohol usage.     

Religious Celebrity: An Analysis of Image Repair Discourse

In all of the communication literature on crisis communication, not one study has been done that looks at the unique situation of a religious person or organization in crisis. This article uses the infamous 1988 crisis of the televangelist Jimmy Swaggart as a case study for religious crisis communication. The theories of Fink (1986 Fink , S. ( 1986 ). Crisis management: Planning for the inevitable . New York : American Management Association . [Google Scholar]) and Benoit (1997 Benoit , W. L. ( 1997 ). Image repair discourse and crisis communication . Public Relations Review , 23 ( 2 ), 177 – 186 .[Crossref], [Web of Science ®] , [Google Scholar]) are used to analyze the situation and explain how Swaggart constructed his image repair campaign. The article also illustrates how these two theories can be used in conjunction to offer a more complete understanding of the crisis situation, and offers a unique look at how religion impacts crisis communication.     

VIA's visual voices: the awareness of a dedicated audience for voices in patient video narratives

First the authors examine the concept of ‘voice’ in one model of participant media research (PMR) giving special attention to parallel variables of hearing, begging questions about the ‘listening’ component of any communication process. Second, they describe the use of a research programme entitled Video Intervention/Prevention Assessment (VIA) and a series of ongoing video narrative projects with chronically ill young people at Children's Hospital Boston. Young people were asked to show how they see their own illness-centred lives by using videocam technology. Third, ‘visual voices’ as found on the videotape results are examined through Thompson's five kinds of voice used by participants living with spina bifida, cystic fibrosis and, in one case, obesity. We conclude that knowledge and anticipation of what we have termed ‘a dedicated audience’ is one of the primary variables in the elicitation of voice and the overall value of participant media research.

… [one] main characteristic of illness narratives is that they formulate and express a central aspect of being ill in modern society, namely the difficulty of giving voice to both suffering and to the lifeworld context of illness. (Hyden 1997 Hyden, L. 1997. Illness and narrative. Sociology of Health & Illness, 19(1): 48–69. [Crossref], [Web of Science ®] , [Google Scholar], 64)