Changes in self-efficacy and readiness for smoking cessation among women with high school or less education

The most common theory of smoking cessation postulates that readiness to quit begins with changes in attitudes that move the smoker toward behavioral change and eventual cessation. However, trends in smoking indicate that many who currently smoke are not ready to quit. Hence, strategies that both enhance readiness and focus on quitting are likely to be most effective. We hypothesize that an intervention addressed to motivating behavior change will enhance readiness to change, which will in turn increase the smokers self-efficacy regarding further change. A smoking cessation intervention that combined a self-help booklet and televised segments was developed to address these issues in a population of women smokers with high school or less education. Readiness to quit was measured prior to the intervention, immediately following the intervention, and again at six and 12 months after intervention. The results indicate that the intervention had its effects on readiness to quit, which in turn affected self-efficacy, which further enhanced readiness to quit. These findings indicate that interventions aimed at this group of smokers may need to provide achievable objectives that focus on preparing the smoker to quit as well as promote cessation.     

Self-Concept,Attitudes Toward Career Counseling,and Work Readiness of Malaysian Vocational Students

The authors examined the relationship between self-concept, attitudes toward career counseling, and work readiness among 574 Malaysian vocational students. Attitudes toward career counseling have been studied in Western cultures; however, little is known about how career counseling is perceived in Eastern cultures. Attitudes toward career counseling were examined as a potential mediator of the relationship between self-concept and work readiness. The authors applied structural equation modeling to explain these relationships. Value of career counseling was found to significantly mediate the link between self-concept and work readiness. Results supported a direct relationship between positive self-concept and work readiness skills. This may be due, in part, to a heightened value of career counseling among vocational students that increases career awareness and thus enhances work readiness. Future research could include samples with more female participants and additional constructs, such as self-efficacy and career adaptability.     

Depressive symptoms and cigarette smoking in a college sample

OBJECTIVE AND PARTICIPANTS: The authors examined (1) the relationship between depressive symptoms and cigarette smoking in a college sample and (2) the role of smoking self-efficacy (one's perceived ability to abstain from smoking) in explaining the relationship between depressive symptoms and cigarette smoking. METHODS: Predominantly first-year college students at a large public university completed a self-report inventory indexing depressive symptoms, cigarette smoking, and smoking self-efficacy. RESULTS: Findings indicated that students high in depressive symptoms smoked significantly more cigarettes per day than did those with low depressive symptoms. Further, among current smokers, smoking self-efficacy explained the relationship between depressive symptoms and cigarette smoking. CONCLUSIONS: These findings add to accumulating evidence that depressive symptoms are a risk factor for increased cigarette smoking in college students. The authors discuss implications for university-based smoking cessation and prevention programs.     

Depressive Symptoms and Cigarette Smoking in a College Sample

Objective and Participants: The authors examined (1) the relationship between depressive symptoms and cigarette smoking in a college sample and (2) the role of smoking self-efficacy (one's perceived ability to abstain from smoking) in explaining the relationship between depressive symptoms and cigarette smoking. Methods: Predominantly first-year college students at a large public university completed a self-report inventory indexing depressive symptoms, cigarette smoking, and smoking self-efficacy. Results: Findings indicated that students high in depressive symptoms smoked significantly more cigarettes per day than did those with low depressive symptoms. Further, among current smokers, smoking self-efficacy explained the relationship between depressive symptoms and cigarette smoking. Conclusions: These findings add to accumulating evidence that depressive symptoms are a risk factor for increased cigarette smoking in college students. The authors discuss implications for university-based smoking cessation and prevention programs.     

A qualitative study of attitudes, beliefs, and practices among 40 undergraduate smokers

OBJECTIVE: Because little is known about college-age smokers, the authors conducted a qualitative study to better understand this population. PARTICIPANTS: Forty college student smokers from 12 Pacific Northwest colleges participated in the study. METHODS: The authors identified themes and built models to ascertain important factors related to smoking and smoking cessation. Four models emerged: smoking facilitators, smoking barriers, cessation facilitators, and cessation barriers. RESULTS: The authors observed physical, psychological, and social influences across models, and social influences were strongly associated with both smoking and cessation. Many smokers were unlikely to define themselves as regular smokers. Most smokers had made prior quit attempts. CONCLUSIONS: College students are a unique category of smoker and colleges can play a role in helping them achieve cessation.     

What really happened? Incidence and factor assessment of abused children and adolescents

Abuse of children and adolescents is a societal problem. If health-care providers are to intervene adequately in abuse, they must identify the occurrence, elicit all pertinent information surrounding the abuse and the patient's response, and integrate pertinent abuse issues in the overall treatment plan for the patient. This study has conclusively demonstrated the failure of health-care providers to assess and plan treatment based on the comprehensive documentation of sexual and physical abuse factors. Findings clearly indicate a need for education of health-care providers in the development of comprehensive and integrated treatment plans for abused psychiatric patients based on documentation of all factors related to trauma learning and replay. Service agencies must be willing to implement in-service programs that provide nurses and other health-care providers with the cognitive and affective knowledge and skills necessary to feel comfortable in the management of abuse issues.     

Do training programs work? An assessment of pharmacists activities in the field of chemical dependency

OBJECTIVES: The primary objective of this study was to determine if a selected sample of pharmacists who had attended a chemical dependency training program were performing more chemical dependency related activities than a group of American Pharmaceutical Association (APhA) members who had not had this training. Additionally, an assessment of the perceived barriers to performing chemical dependencyrelated activities was performed. DESIGN: A confidential mail questionnaire was sent to 305 Utah School participants and 305 APhA members who had not participated in the program (See Appendix). RESULTS: Respondents who had received educational training in chemical dependency were more likely to perform the following activities: lecture to community groups and health care professionals about chemical dependency, participate in a pharmacists' recovery program, provide patients with information about treatment centers, and counsel patients about the alcohol in over-the-counter products. Respondents who had not received chemical dependency training indicated that the following barriers prevented them from taking a more active role in the chemical dependency field: lack of knowledge of chemical dependency resources in the community, unaware of how to get involved with the state recovery program, belief that involvement in the state recovery program would hurt their professional reputation, belief that chemically dependent individuals cannot be rehabilitated, and uncomfortable working with chemically dependent patients. CONCLUSIONS: Pharmacists who have attended substance abuse training programs are performing more chemical dependency activities than pharmacists who have not received training in chemical dependency. In addition, different barriers to performing chemical dependency related activities exist between pharmacists with and without training in this field.     

The conditions for state action in Florida's health-care market.

Despite the lack of confidence in government agencies to operate a nationalized health-care system in the United States, government agencies have significantly influenced the distribution and financing of health-care services in the market. Using the State of Florida as a case study, we examine the conditions under which a state health-care agency can consistently influence health-care market arrangements. We examined records from Florida's legislative sessions between 1965 and 1993 focusing on 27 legislative initiatives to involve the state's health-care agencies in the health-care services market. Using Boolean qualitative comparative analysis (QCA), we examined the conditions that facilitated or inhibited legislative policy initiatives for state action in Florida's health-care services market. The cohesiveness of state administrative agency and legislative leadership is of primary importance. Fragmented interests among health-care providers and fiscally legitimate policy positions, whether those of state agencies or health-care providers, are important enabling factors for state action.     

Implications for Sexual Assault Prevention: College Students as Prosocial Bystanders

Abstract

Prosocial bystander interventions are promising approaches to sexual assault prevention on college campuses. Objective: To assess bystander attitudes among undergraduate students at a northeastern university. Participants: A convenience sample of 188 students from 4 undergraduate classes was surveyed during regularly scheduled class sessions. Methods: Participants completed a short survey on bystander efficacy, readiness to change, and barriers to intervention prior to the start of class. Results: The majority of students were not involved in activities or programs focused on sexual assault prevention. Although students agreed that violence could be prevented, they perceived many barriers to their own participation in intervention. Conclusions: There is a need for gender-targeted prevention programming that introduces the idea of prosocial bystander intervention, with a focus on increasing self-efficacy and lowering barriers.     

Perceptions and Experiences of Marriage Preparation Among U.S. Muslims: Multiple Voices from the Community

Although Muslims in the United States are a growing population, there is limited research on their relational patterns and how they prepare for marriage. We conducted in‐depth interviews with 32 members of the Muslim community in Southeast Michigan including married individuals, divorced individuals, therapists, and imams (Muslim religious leaders) to explore their perceptions and experiences of marriage preparation. Our analysis revealed that marriage preparation varies but is less likely to involve a requirement of premarital counseling, with imams being the primary providers, not therapists. Barriers to participation include stigma, lack of awareness, logistical and financial challenges, and parental influence. Partnerships between imams and therapists, and family and community efforts are necessary to address barriers and increase participation in premarital education programs.     

Internet-Based Interventions for Addictive Behaviours: A Systematic Review

Internet-based interventions have emerged as a new treatment and intervention modality for psychological disorders. Given their features of treatment flexibility, anonymity and confidentiality, this modality may be well suited in the management of addictive behaviours. A systematic literature review of the effectiveness and treatment outcomes of Internet-based interventions for smoking cessation, problematic alcohol use, substance abuse and gambling was performed. Studies were included if they met the following criteria: clients received a structured therapeutic Internet-based intervention for a problematic and addictive behaviour; included more than five clients; effectiveness was based on at least one outcome; outcome variables were measured before and immediately following the interventions; had a follow-up period; and involved at least minimal therapist contact over the course of the program. Sixteen relevant studies were found; nine addressed the effects of Internet-based interventions on smoking cessation, four on gambling, two on alcohol and one on opioid dependence. All studies demonstrated positive treatment outcomes for their respective addictive behaviours. The current review concluded that Internet-based interventions are effective in achieving positive behavioural change through reducing problematic behaviours. This mode of therapy has been found to have the capacity to provide effective and practical services for those who might have remained untreated, subsequently reducing the barriers for help-seekers. This in turn provides imperative information to treatment providers, policy makers, and academic researchers.     

Ready or not: The influence of readiness on healthy marriage and relationship education training outcomes

This exploratory study utilizes a sample of human service providers and administrators to examine personal, agency, and collaborative readiness as predictors of training outcomes (utility reaction, gains in knowledge, and transfer of learning). The study is informed by the child welfare training evaluation model to address the effect of participants' (n = 58) readiness indicators and learning impact in relation to the transfer of learning that takes place following a one-day training. Participants' personal and agency readiness predicted their utility reaction, while personal readiness predicted gains in knowledge. The association between agency readiness and transfer of learning was partially mediated by utility reaction. Implications are drawn for both human service providers and researchers.     

A quit smoking group. Pilot study

1. While the rate of smoking is extremely high among persons with mental illness, there have been efforts to assist this population to quit. A 10-week smoking cessation program was provided for 10 highly nicotine dependent persons with persistent mental illness. 2. No significant differences were found in psychiatric symptoms or drug side effects prior to and after smoking cessation efforts. Four months later, for the 7 subjects who completed the program, 14% were abstinent, 43% maintained reduced tobacco intake, and 43% had resumed previous smoking patterns. 3. Specific barriers to quitting include a lack of nonsmoking coping skills, long-term identity as a smoker, ready access to tobacco products, nicotine addiction, and limited nonsmoking social support.     

Welfare Reform on American Indian Reservations

Abstract

In this article we document trends in welfare caseloads and some initial experiences of service providers and welfare recipients on reservations within Arizona under Temporary Assistance for Needy Families (TANF). We document the issues and concerns of state and tribal service providers as they implement the legislation on reservations that are often geographically isolated and which lack infrastructure, jobs, childcare and transportation. We also record experiences of women with children on reservations with the 1996 federal welfare legislation. These families experience similar barriers when trying to move from welfare to work as do their counterparts across the country; however, these barriers are magnified on reservations. The welfare recipients' barriers include: a shortage of employment opportunities on reservations; a lack of transportation and childcare facilities; low levels of education and job experience; and, individual and family problems. Poor families in Indian communities face additional barriers to employment because of their geographic isolation, lack of access to basic necessities (like telephones), as well as stereotypes and discrimination by employers due to ethnicity or personal/family histories.     

Smoking reduction & cessation: a hospital based survey of outpatients' attitudes

1. Most people with mental illnesses have made at least one attempt to quit smoking on their own. 2. Psychiatric diagnosis and degree of nicotine dependence do not appear to be predictive of ability to quit. 3. People with mental illnesses are aware of nicotine replacement therapy (NRT), but do not combine it with a behavioral program, possibly contributing to the higher rates of recidivism in this population. 4. The lack of participation of mental health care providers in promoting smoking cessation is a complex issue.     

Implementation of an intimate partner violence screening program in a university health care clinic

Abstract

Objectives: To examine whether an intimate partner violence (IPV) screening program is related to a positive change in health care providers’ knowledge, attitudes, and self-efficacy of IPV screening. Participants: Eleven health care providers at a university health care clinic participated in the IPV screening program. Methods: A one-group pretest-posttest design was used to examine whether an IPV screening program was related to a change in health care providers’ knowledge, attitudes, and self-efficacy of IPV screening. Results: Findings indicated that there was a significant difference (p?<?000) between the posttest scores and the pretest scores on the Domestic Violence Healthcare Provider Survey Scale. Domain analysis of the scale revealed a significant difference in perceived self-efficacy (p?=?.001), system support (p?=?<.002), victim provider safety (p?=?.015), and beliefs of blaming victims (p?=?<.004). No statistical difference was found in professional role resistance/fear of offending (p?=?.158). Conclusions: A university health care clinic IPV screening program was related to a positive change in health care providers’ knowledge, attitudes, and self-efficacy of IPV screening.     

Instabile Beschäftigung

Sociologists and economists emphasize the relevance of employment stability for labour market participants and the welfare state. Consequently, changes in the distribution of stable and unstable employment are discussed intensively and controversially. Based on the IAB Employment Subsample 1975–2001 (regional sample) and the second collection of the SFB 580-Firmpanel the paper analyses trends and determinants of employment stability. The results show: Employment becomes more unstable. Past “barriers of mobility” of the job market theory against an expansion of open job markets, like production and receipt of firm specific knowledge or readiness to perform, prove as a little stable.     

Health care providers' readiness to screen for intimate partner violence in Northern Nigeria

Research on screening for intimate partner violence (IPV) within health care in a sub-Saharan African context is rare. This paper assessed factors associated with the readiness to screen for IPV among care providers (HCP, n = 274) at Kano hospital, Nigeria. Readiness was measured using the Domestic Violence Health Care Providers' survey instrument, which measures grade of perceived self-efficacy in screening for IPV, fear for victim/provider safety, access to system support to refer IPV victims, professional roles resistant/ fear of offending clients, and blaming the victim for being abused victim. Social workers perceived a higher self-efficacy and better access to system support networks to refer victims than peers in other occupation categories. Female care providers and doctors were less likely to blame the victim than males and social workers, respectively. Younger care providers of Yoruba ethnicity and social workers were less likely to perceive conflicting professional roles related to screening than older providers of Hausa ethnicity and doctors, respectively. Implications of our findings for interventions and further research are discussed.     

Why rational people do irrational things. The theory of psychological reversals

1. The theory of psychological reversals holds that individuals are inherently inconsistent and that they reverse between metamotivational states. Four pair states have been identified: telic/paratelic; negativistic/conformist; mastery/sympathy; autocentric/allocentric. 2. Individuals interpret motivational variables in different ways depending on the metamotivational states in effect at the time. 3. Health-care providers should recognize that reversals between states are necessary for mental health and they should make allowances for such reversals in their health-care recommendations.     

Lot quality assurance sampling: Information provided to female users of contraceptive methods regarding side effects

Women need to receive accurate information on the proper use of contraceptive methods (CM). The objective of our analysis was to evaluate the quality of CM counseling in health institutions of the public sector using the Lot Quality Assurance Sampling (LQAS) technique. We specifically analyzed whether health-service providers informed CM users of all the side effects they might experience, as specified under the Mexican health-care regulations. Our results demonstrated that, among the four CM analyzed –the intrauterine device, hormonal injection, condom and subdermal implant– only the users of the subdermal implant received complete information on side effects. Our findings thus indicate that the quality of family planning services in the institutions analyzed is deficient. We recommend that service providers be regularly trained in order to improve their performance and that LQAS methodology be adopted as an effective means of regularly monitoring the quality of health services in Mexico.