A Multilevel Analysis of Predictors of Successful Teen Smoking Cessation in the N

青少年成功戒烟预测因素的多层次分析

• 批准号: 7544665
• 负责人: Steven A. Branstetter
• 金额: $ 7.33万
• 依托单位: WEST VIRGINIA UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-08-01 至 2010-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7544665
• 关键词: Accounting; Address; Adolescent; Air; Alcohol consumption; American Lung Association; Arts; Cancer Control; Caring; Centers for Disease Control and Prevention (U.S.); Cessation of life; Characteristics; Classification; Communities; Complex; County; Data; Databases; Disease; Distal; Ecology; Economics; Enrollment; Environment; Equation; Facility Construction Funding Category; Failure; Family; Funding; Future; Gender; Goals; Healthcare; Individual; Intervention; Investigation; Knowledge; Lead; Life Expectancy; Linear Models; Marketing; Medical; Modeling; Modification; Motivation; Murder; Nature; Nicotine Dependence; Numbers; Outcome; Participant; Pharmaceutical Preparations; Police; Policies; Premature Mortality; Public Health; Quality of life; Rate; Readiness; Recruitment Activity; Reporting; Research; Risk; Role; Rural; Schools; Smoke; Smoker; Smoking; Smoking Cessation Intervention; Smoking History; Social Sciences; Statistical Methods; Statistical Models; Structural Models; Structure; Suicide; Techniques; Teenagers; Tobacco; Treatment Failure; United States; United States National Institutes of Health; Withholding Treatment; Work; Youth; abstracting; adolescent smoking; base; cigarette smoking; contextual factors; cost; day; design; improved; information gathering; innovation; multilevel analysis; non-smoker; peer; peer influence; practical application; programs; psychologic; smoking cessation; smoking prevalence; social; success; tobacco prevention; vehicular accident

DESCRIPTION (provided by applicant): Project Summary / Abstract There is little question that cigarette smoking remains one of the nation's most significant and pressing public health concerns. Not only does smoking cost over $96 billion in public and private health care dollars annually, it is responsible for nearly half a million deaths each year. Moreover, for every tobacco related death, there are 20 individuals who are suffering with a tobacco-related disease. Nevertheless, despite research as well as financial and policy efforts geared towards tobacco prevention and cessation, the rates of smoking have remained stable for the last several years. Nevertheless, especially with regard to youth smokers, there continues to be both a significant need and a significant demand for effective cessation programs. Unfortunately, however, there is limited evidence regarding successful youth smoking cessation programs. Because so few programs have been successful, relatively little is known about the socio-demographic, psychological, and contextual characteristics of those teens who undertake structured cessation programs and how these characteristics combine to influence to cessation success or failure. Lack of such knowledge is important because in order to match interventions with those who are most likely to benefit from such programs, as well as to modify existing treatments for those who fail in established interventions, we must first understand the characteristics of those individuals and programs that succeed and those that fail. The present study seeks to address these issues by conducting extensive higher-order analyses, including structural equation modeling and hierarchical linear modeling, of the largest database of teen smokers undergoing cessation treatment in a single, empirically supported intervention - the American Lung Association's Not On Tobacco (NOT) program. By recognizing and attending to the nested nature teen smoking and teen smoking cessation, it is our hope to connect distinct ecological and individual-level variables that influence smoking cessation; thereby illuminating the complex interplay between individual smokers and both his/her proximal and distal social ecology. The contribution of the present study will be significant because it will be the first to evaluate a large database of adolescents seeking to quit smoking through a single empirically supported structured intervention. The results of the proposed study will help determine the role of individual factors (e.g., smoking history, nicotine dependence) as well as several nested factors, including peer smoking environment, cessation group dynamics, and school, community and state level factors. Such knowledge will be critical in the identification of youth at-risk for treatment failure, as well as the identification of critical contextual and policy factors at the individual, local and state level that may relate to smoking cessation success or failure. Project Narrative The proposed study is an extensive analysis of a multiple levels of influence on teen smoking cessation. The state-of-the-art statistical analyses, including structural equation modeling and hierarchical linear modeling, will help illuminate how individual factors, parental and peer influences and school, county and state factors combine to impact the outcomes of teens seeking to quit smoking through an empirically supported cessation program. The proposed research has relevance to public health and cancer control because of the potential that this research has to guide smoking cessation recruitment, program modification, and school, county and state-wide polices regarding smoking.

描述（由申请人提供）：项目摘要 /摘要毫无疑问，吸烟仍然是美国最重要，最紧迫的公共卫生问题之一。吸烟不仅每年造成超过960亿美元的公共和私人保健费用，而且每年造成近50万人死亡。此外，对于每一次与烟草有关的死亡，都有20个人患有与烟草有关的疾病。尽管如此，尽管研究以及为预防烟草预防和停止的研究以及财务和政策努力，但在过去的几年中，吸烟的速度一直保持稳定。然而，尤其是在青年吸烟者方面，既有巨大的需求，又有对有效戒烟计划的重大需求。但是，不幸的是，关于成功的青年戒烟计划的证据有限。因为很少有计划成功，所以对那些采用结构性戒烟计划的青少年的社会人口统计学，心理和上下文特征知之甚少，这些特征如何结合起来影响成功或失败。缺乏这种知识很重要，因为为了将干预措施与最有可能从此类计划中受益的人进行匹配，并为那些在既定干预措施中失败的人修改现有治疗方法，我们必须首先了解这些个人和计划的特征那成功和失败的人。本研究旨在通过进行广泛的高阶分析（包括结构方程建模和分层线性建模）来解决这些问题，该数据库是最大的青少年吸烟者数据库，该数据库在单一的经验支持的干预措施中接受戒烟治疗 - 美国肺部不在烟草中（不）程序。 通过认识并参与筑巢的青少年吸烟和青少年戒烟，我们希望将影响戒烟的独特生态和个人水平变量联系起来。从而阐明了个体吸烟者与他/她的近端和远端社会生态之间的复杂相互作用。本研究的贡献将是重要的，因为它将是第一个评估试图通过单个经验支持的结构化干预措施戒烟的大型青少年数据库的人。拟议研究的结果将有助于确定个体因素（例如吸烟史，尼古丁依赖性）以及几个嵌套因素，包括同伴吸烟环境，戒烟组动态以及学校，社区和州级因素。这种知识对于确定青年处于治疗失败的危险以及可能与戒烟成功或失败有关的个人，地方和州一级的关键背景和政策因素的识别至关重要。项目叙述拟议的研究是对青少年戒烟的多种影响的广泛分析。最先进的统计分析，包括结构方程建模和等级线性建模，将有助于阐明个人因素，父母和同伴的影响以及学校，县和州因素的结合，以影响寻求通过试图通过经验支持的戒烟计划。拟议的研究与公共卫生和癌症控制有关，因为这项研究必须指导戒烟，计划修改以及学校，县和全州范围的警察戒烟。