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  • 1
    Online Resource
    Online Resource
    American Academy of Pediatrics (AAP) ; 2016
    In:  Pediatrics Vol. 138, No. 5 ( 2016-11-01)
    In: Pediatrics, American Academy of Pediatrics (AAP), Vol. 138, No. 5 ( 2016-11-01)
    Abstract: Examine racial/ethnic differences in smoking susceptibility among US youth nonsmokers over time and age. METHODS: We used nationally representative samples of youths who never tried cigarettes (N = 143 917; age, 9–21, mean, 14.01 years) from National Youth Tobacco Survey, 1999 to 2014. We used time-varying effect modeling to examine nonlinear trends in smoking susceptibility adjusted for demographics, living with smokers, and exposure to tobacco advertising. RESULTS: Compared with non-Hispanic whites (NHWs), Hispanics were more susceptible to smoking from 1999 to 2014 (highest adjusted odds ratio [aOR], 1.67 in 2012). Non-Hispanic blacks were less susceptible to smoking than NHWs from 2000 to 2009 (lowest aOR, 0.80 in 2003–2005). Non-Hispanic Asian Americans were less susceptible to smoking from 2000 to 2009 (aOR, 0.83), after which they did not differ from NHWs. Other non-Hispanics were more susceptible to smoking than NHWs from 2012 to 2014 (highest aOR, 1.40 in 2014). Compared with NHWs, non-Hispanic blacks and other non-Hispanics were more susceptible to smoking at ages 11 to 13 (highest aOR, 1.22 at age 11.5 ) and 12 to 14 (highest aOR, 1.27 at age 12 ), respectively. Hispanics were more susceptible to smoking throughout adolescence peaking at age 12 (aOR, 1.60) and age 16.5 (aOR, 1.46). Non-Hispanic Asian Americans were less susceptible to smoking at ages 11 to 15 (lowest aOR, 0.76 at ages 11–13 ). CONCLUSIONS: Racial/ethnic disparities in smoking susceptibility persisted over time among US youth nonsmokers, especially at ages 11 to 13 . Interventions to combat smoking susceptibility are needed.
    Type of Medium: Online Resource
    ISSN: 0031-4005 , 1098-4275
    Language: English
    Publisher: American Academy of Pediatrics (AAP)
    Publication Date: 2016
    detail.hit.zdb_id: 1477004-0
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  • 2
    In: Pediatrics, American Academy of Pediatrics (AAP), Vol. 147, No. 6 ( 2021-06-01)
    Abstract: Susceptibility to future smoking among youth never smokers has not changed in the past 20 years, although experimental cigarette smoking has decreased. We assessed how smoking susceptibility and tobacco industry–related marketing influenced smoking initiation. METHODS: Four waves (2013–2018) of the Population Assessment of Tobacco and Health Study data were analyzed among youth aged 12 to 17 years at wave 1 who completed wave 4. Susceptibility was assessed by 4 items (openness to curiosity, try soon, try in the next year, and if your best friend offered) and categorized into 4 levels (0 = definitely no to all; 1 = yes to 1; 2 = yes to 2; and 3 + 4 = yes to 3 or 4 susceptibility items). Multivariable logistic regression evaluated how susceptibility levels, electronic cigarette use, and tobacco-related media activity predicted future experimental (≥1 puff), current (past 30 days), or established (≥100 cigarettes) smoking. RESULTS: Among 8899 never smokers at wave 1, 16.4% became experimental smokers, 7.6% current smokers, and 1.8% established smokers at wave 4. Black and Latino/a youth were less likely to experiment. Youth who endorsed 3 or 4 susceptibility items at wave 1 were more likely to be experimental (adjusted odds ratio [aOR] = 6.0; confidence interval [CI] = 4.8–7.4), current (aOR = 4.2; CI = 3.2–5.4), or established (aOR = 4.4; CI = 2.4–7.9) smokers at wave 4. Exposure to tobacco marketing, using tobacco-related apps, seeing social media content posted about tobacco, and ever use of electronic cigarettes also predicted experimental smoking. CONCLUSIONS: Smoking susceptibility and exposure to tobacco industry–related marketing were predictive of cigarette smoking. Clinicians should consider screening adolescents for smoking susceptibility and tobacco-related media exposure.
    Type of Medium: Online Resource
    ISSN: 0031-4005 , 1098-4275
    Language: English
    Publisher: American Academy of Pediatrics (AAP)
    Publication Date: 2021
    detail.hit.zdb_id: 1477004-0
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  • 3
    In: JMIR Research Protocols, JMIR Publications Inc., Vol. 9, No. 12 ( 2020-12-31), p. e23669-
    Abstract: Digital behavior change interventions have demonstrated effectiveness for smoking cessation and reducing alcohol intake, which ultimately reduce cancer risk. Leveraging electronic health records (EHR) to identify at-risk patients and increasing the reach of digital interventions through proactive electronic outreach provide a novel approach that may increase the number of individuals who engage with evidence-based treatment. Objective This study aims to increase the reach of digital behavior change interventions by implementing a proactive electronic message system for smoking cessation and alcohol reduction among a large, at-risk population identified through an acute hospital EHR. Methods This protocol describes a 3-phase, mixed-methods implementation study to assess the acceptability, feasibility, and reach of a proactive electronic message system to digital interventions using a hospital’s EHR system to identify eligible patients. In Phase 1, we will conduct focus group discussions with patients and hospital staff to assess the overall acceptability of the electronic message system. In Phase 2, we will conduct a descriptive analysis of the patient population in the hospital EHR regarding target risk behaviors and other person-level characteristics to determine the project’s feasibility and potential reach. In Phase 3, we will send proactive messages to patients identified as smokers or risky drinkers. Messages will encourage and provide access to behavior change mobile apps via an embedded link; the primary outcome will be the proportion of participants who click on the link to access information about the apps. Results At the time of initial protocol submission, data collection was complete, but analysis had not begun. This study was funded by Cancer Research UK from April 2019 to March 2020. Health Research Authority approval was granted in June 2019. Conclusions Increasing the reach of digital behavior change interventions can improve population health by reducing the burden of preventable death and disease. International Registered Report Identifier (IRRID) DERR1-10.2196/23669
    Type of Medium: Online Resource
    ISSN: 1929-0748
    Language: English
    Publisher: JMIR Publications Inc.
    Publication Date: 2020
    detail.hit.zdb_id: 2719222-2
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  • 4
    Online Resource
    Online Resource
    JMIR Publications Inc. ; 2019
    In:  JMIR mHealth and uHealth Vol. 7, No. 10 ( 2019-10-7), p. e14699-
    In: JMIR mHealth and uHealth, JMIR Publications Inc., Vol. 7, No. 10 ( 2019-10-7), p. e14699-
    Abstract: Population-level text messaging smoking cessation interventions may reduce racial and ethnic differences in smoking among pregnant women. Objective Our objective was to examine racial and ethnic differences in dropout, response, and abstinence rates among users of a US national, publicly available text messaging cessation intervention targeting pregnant women, SmokefreeMOM. Methods Participants were online subscribers to SmokefreeMOM who set a prospective quit date within the 9 months before their due date. We examined demographics, smoking frequency, number of cigarettes smoked per day, and prequit time (up to 14 days of preparation time before quit date) as correlates of response rate and abstinence at 8 time points: quit date, day 7, day 14, day 21, day 28, day 35, day 42 (intervention end), and day 72 (1-month follow-up). We conducted survival analysis of time from quit date to dropout by race and ethnicity. Results The mean age of the analytic sample of 1288 users was 29.46 (SD 7.11) years. Of these, 65.81% (848/1288) were white, 16.04% (207/1288) were black, 8.86% (114/1288) were Latina, and 9.29% (120/1288) were multiracial, American Indian/Alaska Native, Native Hawaiian Pacific Islander, or other; 82.68% (1065/1288) had some college education or less. Point-prevalence abstinence was 14.51% (157/1082) on quit day, 3.51% (38/1082) at intervention end, and 1.99% (21/1053) at 1-month follow-up. Black users (hazard ratio 0.68, 95% CI 0.51-0.91) and those with a high school degree or less (hazard ratio 0.66, 95% CI 0.49-0.89) or some college education (hazard ratio 0.75, 95% CI 0.57-0.99) were less likely to drop out than whites or users with a bachelor’s degree or higher. Response and abstinence rates were similar across race, ethnicity, and education. Conclusions Enrollment was low among racial and ethnic minority women but high among less-educated women. Abstinence at intervention end and 1-month follow-up was lower than that in controlled trials of text messaging cessation interventions for pregnant women (range 7%-20%). Increasing the reach, engagement, and effectiveness of SmokefreeMOM, especially among women with high rates of smoking during pregnancy, must be prioritized.
    Type of Medium: Online Resource
    ISSN: 2291-5222
    Language: English
    Publisher: JMIR Publications Inc.
    Publication Date: 2019
    detail.hit.zdb_id: 2719220-9
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  • 5
    In: JMIR Formative Research, JMIR Publications Inc., Vol. 6, No. 7 ( 2022-7-11), p. e34271-
    Abstract: Behavior change apps have the potential to provide individual support on a population scale at low cost, but they face numerous barriers to implementation. Electronic health records (EHRs) in acute care hospitals provide a valuable resource for identifying patients at risk, who may benefit from behavior change apps. A novel, emerging implementation strategy is to use digital technologies not only for providing support to help-seeking individuals but also for signposting patients at risk to support services (also called proactive referral in the United States). Objective The OptiMine study aimed to increase the reach of behavior change apps by implementing electronic signposting for smoking cessation and alcohol reduction in a large, at-risk population that was identified through an acute care hospital EHR. Methods This 3-phase, mixed methods implementation study assessed the acceptability, feasibility, and reach of electronic signposting to behavior change apps by using a hospital’s EHR system to identify patients who are at risk. Phase 1 explored the acceptability of the implementation strategy among the patients and staff through focus groups. Phase 2 investigated the feasibility of using the hospital EHR to identify patients with target risk behaviors and contact them via SMS text message, email, or patient portal. Phase 3 assessed the impact of SMS text messages sent to patients who were identified as smokers or risky drinkers, which signposted them to behavior change apps. The primary outcome was the proportion of participants who clicked on the embedded link in the SMS text message to access information about the apps. The acceptability of the SMS text messages among the patients who had received them was also explored in a web-based survey. Results Our electronic signposting strategy—using SMS text messages to promote health behavior change apps to patients at risk—was found to be acceptable and feasible and had good reach. The hospital sent 1526 SMS text messages, signposting patients to either the National Health Service Smokefree or Drink Free Days apps. A total of 13.56% (207/1526) of the patients clicked on the embedded link to the apps, which exceeded our 5% a priori success criterion. Patients and staff contributed to the SMS text message content and delivery approach, which were perceived as acceptable before and after the delivery of the SMS text messages. The feasibility of the SMS text message format was determined and the target population was identified by mining the EHR. Conclusions The OptiMine study demonstrated the proof of concept for this novel implementation strategy, which used SMS text messages to signpost at-risk individuals to behavior change apps at scale. The level of reach exceeded our a priori success criterion in a non–help-seeking population of patients receiving unsolicited SMS text messages, disconnected from hospital visits. International Registered Report Identifier (IRRID) RR2-10.2196/23669
    Type of Medium: Online Resource
    ISSN: 2561-326X
    Language: English
    Publisher: JMIR Publications Inc.
    Publication Date: 2022
    detail.hit.zdb_id: 2941716-8
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  • 6
    Online Resource
    Online Resource
    Elsevier BV ; 2015
    In:  Journal of Adolescent Health Vol. 57, No. 4 ( 2015-10), p. 448-450
    In: Journal of Adolescent Health, Elsevier BV, Vol. 57, No. 4 ( 2015-10), p. 448-450
    Type of Medium: Online Resource
    ISSN: 1054-139X
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2015
    detail.hit.zdb_id: 2006608-9
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  • 7
    Online Resource
    Online Resource
    Elsevier BV ; 2017
    In:  Social Science & Medicine Vol. 191 ( 2017-10), p. 168-175
    In: Social Science & Medicine, Elsevier BV, Vol. 191 ( 2017-10), p. 168-175
    Type of Medium: Online Resource
    ISSN: 0277-9536
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2017
    detail.hit.zdb_id: 1500748-0
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  • 8
    Online Resource
    Online Resource
    Elsevier BV ; 2020
    In:  American Journal of Preventive Medicine Vol. 58, No. 5 ( 2020-05), p. 666-674
    In: American Journal of Preventive Medicine, Elsevier BV, Vol. 58, No. 5 ( 2020-05), p. 666-674
    Type of Medium: Online Resource
    ISSN: 0749-3797
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2020
    detail.hit.zdb_id: 2020236-2
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  • 9
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2016
    In:  Nicotine & Tobacco Research Vol. 18, No. 7 ( 2016-07), p. 1596-1605
    In: Nicotine & Tobacco Research, Oxford University Press (OUP), Vol. 18, No. 7 ( 2016-07), p. 1596-1605
    Type of Medium: Online Resource
    ISSN: 1462-2203 , 1469-994X
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2016
    detail.hit.zdb_id: 2020202-7
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  • 10
    In: Chronobiology International, Informa UK Limited, Vol. 38, No. 1 ( 2021-01-02), p. 1-26
    Type of Medium: Online Resource
    ISSN: 0742-0528 , 1525-6073
    Language: English
    Publisher: Informa UK Limited
    Publication Date: 2021
    detail.hit.zdb_id: 2026725-3
    SSG: 12
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