Frederick J. Kviz

Evaluating multiple outcomes and gender differences in alcoholism treatment

This study followed 592 alcoholics (180 women and 412 men) after discharge from inpatient treatment. Multiple measures of treatment outcome were used to broaden our understanding of the process of recovery from alcohol abuse, and how that process differs for men and women. Patients were interviewed by telephone between 3 and 15 months after discharge to gather information about post-treatment experiences including: relationship with family, role performance, psychological impairment, and effort toward recovery. Additionally, if any alcohol use took place after treatment, information was collected about the pattern of alcohol consumption. Results indicated being married is consistently related to less drinking for men, while for women, being married contributes to relapse in the short term. The determinants of each measure of outcome were different for women and men, indicating that the process of recovery is not the same for both genders. The study confirms that drinking is related to other adverse outcomes for men, but not necessarily for women. It is evidence that women and men have different post-treatment functioning, and that different characteristics are predictive of these outcomes.

Toward a Standard Definition of Response Rate

As RECENTLY noted by the American Statistical Association (1974) and by Berdie and Anderson (1976), there is a high degree of variability in the definition of response rates currently employed by survey researchers. The absence of a standard definition has caused a great deal of confusion regarding the interpretation of reported response rates and has frustrated methodological investigations because of a lack of comparative data. The response rate should reflect the degree to which a researcher succeeds in obtaining the cooperation of all potential respondents included in the sample. Accordingly, it is logical to define it as the proportion of all sample members who are eligible to participate in the survey from whom a complete and usable set of data is collected. This is expressed in formula (1).

Age and the role of symptomatology in readiness to quit smoking

To develop effective age-appropriate strategies for smoking cessation, it is important to understand factors associated with readiness to quit smoking. This article presents results from an analysis of the role of symptomatology in the decisions to quit smoking among three age groups (18-34, 35-54, and > or = 55 years) from a larger sample of smokers in a managed-care setting. Two measures of readiness to quit smoking were used: stages of change and intention to stop. Using ordinal logistic regression, we found that smokers in the middle and oldest age groups who had experienced at least three of five symptoms in the previous 2 weeks were more likely to be in higher stages of readiness. Regardless of age, smokers who attributed symptoms to smoking were more motivated to try to quit, whereas those who attributed symptoms to aging were less likely to intend to stop smoking. Findings from this study indicate a symptom-based approach to smoking cessation may be a useful strategy, especially in provider-based interventions.

Identifying individual and contextual barriers to seeking mental health services among Korean American immigrant women

The purpose of this qualitative study was to explore perceptions about barriers to Korean American immigrant womens seeking mental health services. Four focus groups were conducted with 27 Korean American participants, including two groups of providers and two groups of community women. Discussions were recorded and transcribed to identify and code themes. Barriers included language problems, cultural differences, lack of time, financial limitations, lack of transportation, lack of knowledge, lack of funding for community agencies, lack of partnership with churches, and perceived stigma. Recommendations include ethnically and linguistically matched mental health services, community outreach services, training for providers, and community education.

Characteristics of participants in a televised smoking cessation intervention

Participants in various components of a televised self-help smoking cessation program, based on the American Lung Associations Freedom From Smoking in 20 Days, are compared with a sample of the population of smokers to whom the intervention was addressed. Over 325,000 smokers in the target population were exposed to the program at some level. Most watched televised segments. Approximately 75,000 manuals were distributed and about 55,000 were used. Comparisons between participants and the targeted smoking population indicate that the intervention attracted those in the smoking population who are expected to be the majority of smokers by the Year 2000-blacks, females, and those with incomes under

Use and Effectiveness of Buddy Support in a Self-Help Smoking Cessation Program

13,000 per year. Participants with these characteristics were most likely to view the televised segments. Heavy smokers, females, and those with the most education were most likely to refer to the manual at least twice a week during the intervention. Older, nonblack participants and those with incomes of

Psychosocial Factors and Enrollment in a Televised Smoking Cessation Program

13,000 or more per year were most likely to attend group support sessions outside the home. Overall, the patterns of association indicate that although a televised smoking cessation program can attract individuals similar to those projected to be smokers in 2000, participation in various components of the intervention will vary by demographic characteristics.

The Effect of a Couples Intervention to Increase Breast Cancer Screening Among Korean Americans

Purpose. This study assesses buddy support in a community-based, minimal-contact smoking cessation program. Design. Telephone interviews with participants (n=641, response=74%) before and after (end-of-program, n=1, 023, response=83%; three months n=757, response=74%; six months, n=859, response=84%; and 12 months, n=713, response=70%) intervention provided the data to be analyzed. Setting. The Chicago metropolitan area was the setting. Subjects. Subjects were a random sample of registrants for the intervention program. Intervention. A self-help smoking cessation program was used, which included a manual and complementary televised segments. Engaging a buddy was optional. Measures. Background and psychosocial characteristics of participants, characteristics of buddies, program compliance, and smoking behavior were the measures used. Results. Almost one third (30.3%) engaged a buddy. Those most likely to engage a buddy were female (33.4%), younger than 30 (37.2%), educated beyond high school (33.4%), highly determined to quit (41.8%), and more likely to need help from others (39.8%). More than half of the buddies were from outside the participants household (55.1%), and more than half were nonsmokers (60.9%). Having a buddy was associated positively with manual use (gamma=.38), viewing televised segments (gamma=.23), recalling manual segments (gamma=.33), and recalling televised segments (gamma=.26). Among those who read the manual least, having a buddy was associated with viewing televised segments (gamma=.26, p<.05) and with end-of-program quitting (16.8% vs. 9.8%, p<.05). Having a buddy also was associated with higher abstinence through 12 months (5.8% vs. 2.7%, p=.013). Among those with lower determination, the end-of-program quit rate was more than three times greater (p=.013) for those with a buddy (16.1 %) than without a buddy (5.2%). Participants whose buddy was their spouse or partner were more likely to quit at end-of-program (29.1% vs. 18.4%, p=.031). Conclusions. Buddy support should be promoted as an adjunct to minimal-contact smoking cessation programs. Impact of buddy support might be improved by guiding participants in choosing a buddy.

Differential response effects of data collection mode in a cancer screening study of unmarried women ages 40-75 years: a randomized trial.

Registrants for a smoking cessation program on the evening television news in the Chicago metropolitan area were compared with other smokers in the population to identify psychosocial factors that distinguished registrants. Telephone interviews were conducted before the intervention with random samples of 641 registrants and 2,398 smokers who regularly viewed the evening news. A nested series of three contrasts compared registrants with (1) smokers who regularly viewed the evening television news on any channel, (2) smokers who were regular viewers of the evening news on the intervention channel, and (3) smokers who were regular viewers of the evening news on the intervention channel and were planning to quit smoking. Registration was associated with a smokers cognitive appraisal of the quitting process, with registrants distinguished by (1) recognition of a need to act (perceived severity of and susceptibility to lung cancer), (2) high outcome expectancies for quitting as an effective means for health promotion, (3) realistic expectations about the effort required to quit, (4) concern about the burden of lung cancer on significant others and related social influence factors, and (5) motivation to quit smoking. The findings suggest that the effectiveness of minimal-contact intervention programs may be enhanced by targeting smokers according to their psychosocial characteristics and by cognitively preparing smokers to attempt to quit.

Factors associated with nonparticipation among registrants for a self-help, community-based smoking cessation intervention☆

PURPOSE/OBJECTIVES To assess the efficacy of Korean Immigrants and Mammography-Culture-Specific Health Intervention (KIM-CHI), an educational program for Korean American (KA) couples designed to improve mammography uptake among KA women. DESIGN A two-group cluster randomized, longitudinal, controlled design. SETTING 50 KA religious organizations in the Chicago area. SAMPLE 428 married KA women 40 years of age or older who had not had a mammogram in the past year. The women and their husbands were recruited from 50 KA religious organizations. METHODS Couples were randomly assigned to intervention or attention control groups. Those in the KIM-CHI program (n = 211 couples) were compared to an attention control group (n = 217 couples) at baseline, as well as at 6 and 15 months postintervention on mammogram uptake. MAIN RESEARCH VARIABLES Sociodemographic variables and mammography uptake were measured. Level of acculturation was measured using the Suinn-Lew Asian Self-Identity Acculturation Scale. Researchers asked questions about healthcare resources and use, health insurance status, usual source of care, physical examinations in the past two years, family history of breast cancer, and history of mammography. FINDINGS The KIM-CHI group showed statistically significant increases in mammography uptake compared to the attention control group at 6 months and 15 months postintervention. CONCLUSIONS The culturally targeted KIM-CHI program was effective in increasing mammogram uptake among nonadherent KA women. IMPLICATIONS FOR NURSING Nurses and healthcare providers should consider specific health beliefs as well as inclusion of husbands or significant others. They also should target education to be culturally relevant for KA women to effectively improve frequency of breast cancer screening.