Karen Bogen

Receptivity to Taboka and Camel Snus in a U.S. test market.

INTRODUCTION The two largest U.S. cigarette manufacturers introduced Swedish-style low-nitrosamine smokeless tobacco (snus) to several U.S. test markets in summer 2006. Since then, snus brands and test markets have proliferated. METHODS This article assesses consumer response by analyzing data from the 2006 and 2007 Indiana Adult Tobacco Survey (IATS), a statewide telephone survey of 3,544 adults. During those years, the IATS included questions on awareness and trial of Camel Snus and Taboka. Analyses examined rates and predictors of awareness and trial statewide, and within the central Indiana test market. RESULTS Nineteen percent of Indiana adults were aware of either Taboka or Camel Snus in 2006 and 2007. Estimates are larger (29%) for central Indiana and larger still (70%) for central Indiana smokers. Trial of snus, however, was very low (1.5% statewide), except among male smokers in central Indiana, 20% of whom are estimated to have tried it. Multivariate analyses showed that trial was more likely among men than women (odds ratio [OR] 13.85), residents of central Indiana than those farther from Indianapolis (OR 2.96), recipients than nonrecipients of tobacco promotions (OR 6.08), and those believing that smokeless tobacco is less harmful than cigarettes compared with those who believe it is equally or more harmful (OR 3.86). DISCUSSION Results from this study suggest substantial initial interest in the new products among male smokers in this test market, especially those who receive promotional mailings from tobacco companies, which often include coupons for free or discounted products.

A Randomized Trial Comparing Mail versus In-Office Distribution of the CAHPS Clinician and Group Survey

OBJECTIVE To assess the effect of survey distribution protocol (mail versus handout) on data quality and measurement of patient care experiences. DATA SOURCES/STUDY SETTING Multisite randomized trial of survey distribution protocols. Analytic sample included 2,477 patients of 15 clinicians at three practice sites in New York State. DATA COLLECTION/EXTRACTION METHODS Mail and handout distribution modes were alternated weekly at each site for 6 weeks. PRINCIPAL FINDINGS Handout protocols yielded an incomplete distribution rate (74 percent) and lower overall response rates (40 percent versus 58 percent) compared with mail. Handout distribution rates decreased over time and resulted in more favorable survey scores compared with mailed surveys. There were significant mode-physician interaction effects, indicating that data cannot simply be pooled and adjusted for mode. CONCLUSIONS In-office survey distribution has the potential to bias measurement and comparison of physicians and sites on patient care experiences. Incomplete distribution rates observed in-office, together with between-office differences in distribution rates and declining rates over time suggest staff may be burdened by the process and selective in their choice of patients. Further testing with a larger physician and site sample is important to definitively establish the potential role for in-office distribution in obtaining reliable, valid assessment of patient care experiences.

Impact of corrective health information on consumers’ perceptions of “reduced exposure” tobacco products

Objective: To determine whether providing corrective health information can reduce the tendency of consumers to believe that the implied marketing message that two “potentially reduced exposure products” (PREPs) are safer than regular cigarettes. Design: Face-to-face interviews with smokers assigned to one of four conditions, which varied in terms of the presence or absence of health information that qualified claims made in advertising for two PREPs. Subjects: A convenience sample of 177 smokers in Boston area. Interventions: Health information detailed the extent to which exposure to toxins and health risks of the brands were unknown. Main outcome measures: Respondents’ assessments of the health risks and toxicity of the two combustible PREPs, Advance and Eclipse. Results: The health information had a modest but significant effect on ratings of health risk, and reduced perceptions that switching to the new brands would lower a smoker’s risk of cancer (OR 0.75; p<0.05). The health information had no effect on perceptions of toxicity. Conclusions: A small dose of corrective information was effective in tempering smokers’ perceptions. A higher dose of public health campaigns would be needed to affect misperceptions likely to follow a full-scale tobacco marketing effort.

Unmet needs for home and community-based services among persons with disabilities in Massachusetts.

BACKGROUND Home and community-based services (HCBS) are vital to the health and well-being of persons with disabilities. However, no previous population-based studies have examined the prevalence of unmet needs for HCBS among working-age persons with disabilities. The purpose of this report is to document the prevalence of unmet need for HCBS among a representative sample of working-age persons with disabilities in Massachusetts. METHODS Data from the 2007 Massachusetts Survey of Unmet Needs of Adults with Disabilities were analyzed. HCBS included in-home help, case-management, information, access to medical care, physical and occupational therapy, prescription drugs, meals, assistive technology, home adaptation, transportation, need for assistance with activities of daily living and instrumental activities of daily living (IADL) services. RESULTS The prevalence of unmet need for HCBS was high, with more than two-thirds of respondents reporting at least 1 unmet need and more than 1 in 4 respondents reporting 4 or more unmet needs. The most prevalent unmet need included the need for information for disability-related services and legal rights, need for primary, specialty, and mental health care, case management services and the unmet need for IADL services. The unmet needs for HCBS were categorized into unmet needs relating to access to information and services and those relating to in-home supports. CONCLUSIONS The study findings support the need to broaden the scope of HCBS for working-age persons with disabilities and to implement community-based programs such as improving access to information for services and benefits and enhancing access to in-home supports.

Effectiveness of Supplemental Educational Services

Abstract: One of the modifications of the Elementary and Secondary Education Act (known as the No Child Left Behind Act) gave parents of low-income students in low-performing schools a choice of Supplemental Educational Services (SEdS). SEdS include tutoring or other academic support services offered outside the regular school day, at no charge to students or their families, by public or private organizations that have been approved by the state. We examine the impacts of SEdS on test scores among 24,000 students in school districts where SEdS were oversubscribed in Florida, Ohio, and Connecticut. Oversubscribed school districts are required to make SEdS available to the lowest achieving students among eligible applicants, creating the opportunity to estimate impacts using a regression discontinuity design, which relies on districts’ use of a continuous measure of prior academic achievement to determine which eligible applicants will be offered services. We find no impact of SEdS on student test scores.