Search

Objective: The purpose of this study was to gain insight about patterns of alcohol use and related consequences among heavy drinking community college students. Participants: About 26 community college students (Mean age 22.3 years, 46% men, 69% White) participated in this study between January and April 2013. Methods: Five qualitative focus group discussions were conducted during formative research preceding a text message intervention; participants were asked about common drinking behavior patterns among community college students, as well as how age and gender affect drinking. Sessions were audio-recorded and transcribed verbatim. Participants also completed a brief quantitative survey about their drinking behavior and its consequences. Results: Qualitative data identified several themes: (1) reasons for drinking, (2) drinking occasions, (3) age- and experience-related differences in drinking, including patterns specific to community college students and women. Conclusion: Research is needed to develop innovative strategies to reduce alcohol harm in this understudied population. [ABSTRACT FROM AUTHOR]

Abstract Youth exiting foster care represent a unique, at-risk population in that they receive supportive health services while under the umbrella of the foster care system, but access to care can drop precipitously upon release from foster custody. Traditional means of substance use treatment may not meet the needs of this vulnerable population. Mobile interventions, however, have demonstrated high acceptability and efficacy across a range of mental and physical health issues. The specific advantages to mobile interventions dovetail well with the barriers faced by youth exiting foster care. This study describes the feasibility, acceptability, and initial efficacy of iHeLP, a computer- and mobile phone-based intervention based in Motivational Interviewing for reducing substance use among youth exiting foster care (n = 33). Participants were randomly assigned to either iHeLP or a contact control, each of which lasted six months. Feasibility was evaluated through eligibility and enrollment rates at baseline, and retention and intervention reach rates 3, 6, 9, and 12 months later. Acceptability was measured through a 5-item satisfaction measure and exit interviews. The two groups were then compared on a monthly measure of substance use. Study enrollment, retention, response rate, engagement, and satisfaction were all very good. Participants receiving iHeLP reported higher percent days abstinent than the control group, with effect sizes ranging from 0.32 to 0.62. Technology-based interventions such as iHeLP may be attractive to this population and support efforts towards reductions in substance use. Highlights • Youth who have experienced foster care report high levels of substance use. • Traditional approaches to substance use service provision may not meet the unique needs of this population. • We developed a computer- and mobile phone-based intervention for reducing substance use among youth exiting foster care. • Feasibility, acceptability, and preliminary efficacy were strong. • Technology-based interventions may be an engaging alternative to reduce substance use among youth exiting foster care. [ABSTRACT FROM AUTHOR]

Background Despite reductions in cigarette smoking in the U.S., improvements in the efficacy of smoking cessation treatments are needed, as rates of sustained abstinence remain disappointingly low. Both low positive affect and high negative affect contribute to smoking relapse and constitute viable targets for smoking cessation interventions. Although some clinical trials have evaluated interventions to address depression as a smoking relapse risk factor, very few have focused on positive affect. Recently, we developed and conducted a preliminary clinical trial of a smoking cessation treatment that targets positive affect and cognitions by incorporating interventions rooted in positive psychology. The current randomized controlled trial will expand upon this preliminary trial to test whether this positive psychology-informed approach results in higher smoking cessation rates compared to a time-matched standard smoking cessation treatment control. Methods Three hundred and forty adult daily smokers will be randomly assigned to either positive psychotherapy for smoking cessation or standard behavioral smoking cessation counseling. Participants will meet weekly with a study counselor for 6 weeks and will receive transdermal nicotine patch and text messaging smoking cessation support. Additionally, text messaging in the positive psychotherapy condition will encourage engagement in positive psychology-specific strategies for boosting mood and staying smoke free. Smoking cessation outcomes will be measured at 12, 26, and 52 weeks following target quit date. Conclusion Results from this study will provide evidence on whether incorporating positive psychology interventions into smoking cessation treatment can improve smoking cessation outcomes relative to standard behavioral counseling with nicotine patch and text messaging. [ABSTRACT FROM AUTHOR]

Youth who are aging out of the foster care system face significant barriers to accessing substance use treatment. Mobile interventions have shown efficacy for several mental and physical health issues and may be helpful in overcoming barriers facing foster youth with substance use problems. A program (iHeLP) for substance use reduction was developed that used a computerized screening and brief intervention (SBI) followed by six months of dynamically-tailored text messages. The program was shown to focus groups of youth (N = 24) ages 18–19 who recently left foster care and had moderate to severe substance use risk. Focus group feedback was used to modify iHeLP prior to delivery in an open trial (N = 16). Both study phases included assessments of feasibility and acceptability; the open trial also included assessments of substance use outcomes at 3 and 6 months. Focus groups indicated a high level of acceptability for the proposed intervention components. Of those screened for the open trial, 43% were eligible and 74% of those eligible enrolled, indicating good feasibility. Retention through the final follow-up was 59%, and drop out was associated with involvement in the criminal justice system. Participant ratings for liking, ease of working with, interest in and respectfulness of the SBI were high. Satisfaction ratings for the texting component were also high. A computerized brief screening intervention for substance use risk reduction together with tailored text messaging is both feasible and highly acceptable among youth who have recently aged-out of foster care. [ABSTRACT FROM AUTHOR]

The purpose of this meta-analysis was to examine the effects of yoga for glycemic control among adults with type 2 diabetes (T2DM). Comprehensive electronic databases searches located 2559 unique studies with relevant key terms. Studies were included if they (1) evaluated a yoga intervention to promote T2DM management, (2) used a comparison group, (3) reported an objective measure of glycemic control at post-intervention, and (4) had follow-up length or post-test of at least 8weeks from baseline. Independent raters coded participant, design and methodological characteristics and intervention content. Summary effect sizes and 95% confidence intervals (CI) were calculated. Twenty-three studies with 2473 participants (mean age=53years; 43% women) met eligibility criteria. Compared with controls, yoga participants were successful in improving their HbA1c (d+=0.36, 95% CI=0.16, 0.56; k=16), FBG (d+=0.58, 95% CI=0.40, 0.76; k=20), and PPBG (d+=0.40, 95% CI=0.23, 0.56; k=14). Yoga was also associated with significant improvements in lipid profile, blood pressure, body mass index, waist/hip ratio and cortisol levels. Overall, studies satisfied an average of 41% of the methodological quality (MQ) criteria; MQ score was not associated with any outcome (Ps >0.05). Yoga improved glycemic outcomes and other risk factors for complications in adults with T2DM relative to a control condition. Additional studies with longer follow-ups are needed to determine the long-term efficacy of yoga for adults with T2DM. [ABSTRACT FROM AUTHOR]

Latent class modeling (LCM) offers a promising approach for examining correlates of heart rate (HR) patterns over multiple exercise sessions. This research examined biological and psychological variables associated with different patterns of HR response to physical activity (PA). In a three-arm randomized controlled trial (exercise video games vs. standard exercise vs. non-exercise control), HR was recorded during PA sessions over a 12-week period. LCM identified three patterns of HR during PA across 189 participants in active arms: 1) high HR across sessions with low variability within sessions, 2) linear increase in HR across sessions with low variability within sessions, and 3) high variability in HR across all sessions. Associations with biological (resting heart rate, blood pressure, BMI, age, cholesterol, triglycerides, HbA1c) and psychological (depression, motivations for PA, PA-induced feelings) predictors of latent class membership were iteratively tested. Psychological variables played as important a role in the final model as biological variables for predicting latent class membership. Few differences were found between LC1 and LC2, but LC3 differed from the other two groups in that participants were likelier to report that they feel revitalized after PA (vs. LC1 and LC2), to be less motivated for PA (vs. LC1), reported greater depression (vs. LC1 and LC2), and were younger (vs. LC1). These findings demonstrate the potential of LCM to identify biological and psychological factors associated with chronotropic responses to PA, and advance understanding of the role of psychological factors in chronotropic PA outcomes. • Latent class modeling found three patterns in heart rate during an exercise trial. • Baseline psychological variables were key predictors of these patterns. • Psychological covariates may be important to patterns of heart rate during exercise. • Results have implications for wearable fitness trackers. [ABSTRACT FROM AUTHOR]

Background: Internet access has grown markedly in Latinos during the past decade. However, there have been no Internet-based physical activity interventions designed for Latinos, despite large disparities in lifestyle-related conditions, such as obesity and diabetes, particularly in Latina women. The current study tested the efficacy of a 6-month culturally adapted, individually tailored, Spanish-language Internet-based physical activity intervention. Methods: Inactive Latinas (N=205) were randomly assigned to the Tailored Physical Activity Internet Intervention or the Wellness Contact Control Internet Group. Participants in both groups received emails on a tapered schedule over 6 months to alert them to new content on the website. The primary outcome was minutes/week of moderate to vigorous physical activity (MVPA) at 6 months as measured by the 7-Day Physical Activity Recall; activity was also measured by accelerometers. Data were collected between 2011 and 2014 and analyzed in 2015 at the University of California, San Diego. Results: Increases in minutes/week of MVPA were significantly greater in the Intervention Group compared to the Control Group (mean difference = 50.00, SE = 9.5, p < 0.01). Increases in objectively measured MVPA were also significantly larger in the Intervention Group (mean differences = 31.0, SE= 10.7, p<.01).The Intervention Group was also significantly more likely to meet national physical activity guidelines at 6 months (OR = 3.12, 95 % CI 1.46-6.66, p < .05). Conclusion: Findings from the current study suggest that this Internet-delivered individually tailored intervention successfully increased MVPA in Latinas compared to a Wellness Contact Control Internet Group. [ABSTRACT FROM AUTHOR]

Internet-based interventions show promise as an effective channel for promoting physical activity. However, a paucity of research has been conducted among underserved groups despite recent increases in Internet access and physical activity-related health disparities in these communities. Thus, the current randomized controlled trial will test the efficacy of an individually tailored, Internet-based physical activity intervention for Latinas. This program was culturally and linguistically adapted for the target population through extensive formative research. Two hundred eighteen sedentary Latinas were randomly assigned to the Tailored Physical Activity Internet Intervention or the Wellness Contact Control Internet Group. The Physical Activity Internet Intervention, based on Social Cognitive Theory and the Transtheoretical Model, utilizes a website with features including self-monitoring, goal setting, discussion forum, links to online resources, individually tailored and motivation-matched physical activity feedback reports, and exercise tip sheets. Participants receive regular emails over the first 6 months with a tapered dose during the second 6 months (maintenance phase) to alert them to new content on the website. The main outcome is differences in minutes/week of moderate to vigorous physical activity at six months as measured by the 7-Day Physical Activity Recall and accelerometer data. High reach, low cost, culturally relevant Internet-based interventions that encourage physical activity among Latinas could help reduce health disparities and thus have a substantial positive impact on public health. [ABSTRACT FROM AUTHOR]

Background: Physical activity interventions designed for Latinas have shown short-term behavior change, but longer-term change and maintenance is rarely measured. Purpose: To assess physical activity change at 12 months, following 6-month tapered completion of an RCT of a physical activity intervention for Latinas. Methods: Two hundred sixty-six underactive (<60 minutes/week physical activity) Latinas were randomized to an individually tailored, culturally and linguistically adapted physical activity intervention, or a wellness contact control. Participants received the materials through the mail for 6 months, then received booster doses at 8, 10, and 12 months. Minutes per week of moderate to vigorous physical activity were measured by the 7-Day Physical Activity Recall interview at baseline and 6 and 12 months. Data were collected at Brown University between 2009 and 2013, and analyses were conducted in 2013. Results: At 12 months, increases in moderate to vigorous physical activity were significantly greater in the intervention than in the wellness group (mean difference=52 minutes/week, SE=9.38, p<0.01), with both groups showing slight increases in moderate to vigorous physical activity from 6 to 12 months. Intervention participants were also more likely to meet national moderate to vigorous physical activity guidelines (OR=3.14, p=0.01). Conclusions: The intervention was more effective than the wellness control at 12 months, and physical activity increases from baseline to 6 months were maintained, suggesting the intervention may lead to sustainable behavior change. [ABSTRACT FROM AUTHOR]

Background: Latinas in the U.S. are less physically active than non-Latino white women and also report higher levels of diabetes, obesity, and other conditions related to inactivity. Interventions are needed to address disparities in this high-risk group. Purpose: To evaluate the efficacy of a culturally adapted, Spanish-language, individually tailored, computer expert system–driven physical activity print-based intervention for adult Latinas. Design: RCT. Setting/participants: Participants were 266 inactive adult Latinas who participated between 2009 and 2012. Intervention: Participants were randomized to one of two treatment arms: a 6-month tailored physical activity intervention condition or wellness contact control. For both conditions, print materials were delivered by mail. Main outcome measures: The main outcome measure was change in weekly moderate-to-vigorous physical activity (MVPA) measured by the 7-Day Physical Activity Recall interview, which was administered at baseline and post-intervention (6 months). Participants also wore accelerometers for a week at baseline and follow-up. Analyses were conducted in 2013. Results: Increases in minutes/week of MVPA measured by the 7-Day PAR were significantly greater in the intervention group compared to the control group (mean difference=41.36, SE=7.93, p<0.01). This difference was corroborated by accelerometer readings (rho=0.44, p<0.01). Further, results indicate that intervention participants had greater increases in self-efficacy, cognitive processes, and behavioral processes at 3 months compared to control paricipants (p’s<0.05). Conclusions: The tailored Spanish-language intervention was effective in increasing MVPA among predominantly low-income, less-acculturated Latinas. Such print-based interventions are poised for widespread dissemination, and thus may help address health disparities. [Copyright &y& Elsevier]

Background: Vigorous-intensity exercise has been shown to aid in smoking cessation, especially among women. In a previous trial, cognitive behavioral therapy (CBT) for smoking cessation plus regular vigorous aerobic exercise enhanced cessation rates, improved exercise capacity, and reduced weight gain compared to CBT plus equal contact time. Purpose: This study examined the effectiveness of this program adapted for and implemented in the YMCAs. Design: An RCT comparing CBT + Exercise (Exercise) to CBT + Contact Control (Control). Setting/participants: Apparently healthy female smokers were recruited to four local YMCAs. Intervention: YMCA staff members were trained to lead the manualized CBT smoking-cessation intervention and a standardized YMCA exercise program. Main outcome measures: Seven-day point prevalence and continuous abstinence. Results: Participants (330 women, mean age=44 years) were randomized to the Exercise (n=166) or Control (n=164) group. Results revealed no differences in 7-day point prevalence (29.5% vs 29.9%) nor continuous abstinence (13.9% vs 14.0%) between the Exercise and Control groups, respectively, at end of treatment or at the 3-, 6-, and 12-month follow-up. An examination of the relationship between exercise dose and quit status at end of treatment revealed that over 12 weeks, the odds of being quit (7-day point prevalence) grew by 4.5% for each additional aerobic exercise session (OR=1.05, 95% CI=1.01, 1.08) and by 7.7% for each additional resistance training session (OR=1.08, 95% CI=1.02, 1.14). Analyses were conducted between August 19, 2010, and December 16, 2011. Conclusions: No differences were seen between groups in smoking outcomes. The association between greater exercise participation and higher odds of quitting within the exercise condition suggests that the lack of between-group differences might be a result of poor compliance with the exercise program. Trial registration: This study is registered at clinicaltrials.gov NCT01615380. [Copyright &y& Elsevier]

Latina women report disproportionately high rates of physical inactivity and related chronic health conditions. Physical activity (PA) efforts to date have shown modest success in this at-risk population; thus, more effective interventions are necessary to help Latinas reach national PA guidelines and reduce related health disparities. This paper describes the design, rationale, and baseline findings from the Seamos Activas II intervention. The ongoing RCT will test the efficacy of the Seamos Saludables PA print intervention vs. a theory-and technology-enhanced version (Seamos Activas II). The purpose of the study is to increase the percentage of Latinas meeting the national PA guidelines compared to the prior trial, improve biomarkers related to disease, and extend generalizability to a broader and more representative population of Latinas (i.e. Mexican/Mexican-Americans). Intervention refinements included further targeting key constructs of Social Cognitive Theory, and incorporating interactive text message-based self-monitoring strategies. The primary outcome is change in minutes per week of MVPA measured by ActiGraph GT3X+ accelerometers at 6- and 12-months. Secondary PA outcomes assessed by the 7-Day PA Recall will be used to corroborate findings. Participants (N = 199) are Latinas 18–65 years (mean = 43.8) of predominantly Mexican origin (89%). At baseline, objectively measured MVPA was 39.51 min/week (SD = 71.20, median = 10) and self-reported MVPA was 12.47 min/week (SD = 22.54, median = 0).Participants reported generally low self-efficacy and higher cognitive vs. behavioral processes of change. Addressing interactivity and accountability through text messaging, and more rigorously targeting theoretical constructs may be key to helping Latinas achieve nationally recommended PA levels and thereby reducing health disparities. [ABSTRACT FROM AUTHOR]

Background: This research aimed at understanding how changes in one behavior affect other behaviors, known as "transfer effect," could extend knowledge of shared constructs among compound health risk behaviors, and improve methods for promoting simultaneous behavior changes. The current study explored whether participants who completed a randomized controlled trial for physical activity (PA) improved their diet with no intervention in diet or nutrition., Methods: US adults (N = 283) were randomly assigned to 12 weeks of either exercise videogames, standard exercise, or an attention control. Secondary analyses were conducted to examine a possible transfer effect of the intervention on diet at end of intervention (EOT) and 6-month follow-up. Assessments of potential PA constructs (i.e., exercise enjoyment, self-efficacy) and demographics (e.g., age, gender) were conducted. PA, specifically moderate-to-vigorous levels of physical activity (MVPA), was measured using a self-report measure. Diet was measured using the Rate Your Plate dietary assessment., Results: Findings support that a randomization effect was associated with a higher likelihood of increasing MVPA (β = 30.00, 95% CI = 4.46, 64.46) and dietary improvement at EOT (β = 1.48, SE = .83, P = .01) and follow-up (β = 1.74, SE = .52, P = .02). At EOT, changes in diet were associated with higher PA enjoyment (β = 0.41, SE = 0.15, P = .01). This intervention effect on diet was moderated by gender, with women showing more dietary improvement than men (β =  - .78, SE = 13, P = .03). At 6 months, dietary improvement was associated with greater self-efficacy (β = .04, SE = .01, P = .01)., Conclusion: This study shows evidence of a transfer effect among two synergistic behaviors and expands understanding of factors that predict the occurrence of this type of behavior change., (© 2023. International Society of Behavioral Medicine.)

Objectives: While previous research has utilized remote delivery of yoga interventions, no research has specifically interrogated the effectiveness of remote yoga intervention delivery. In this secondary analysis of weight-maintenance trial data, we examined participant perceptions of essential yoga properties across in-person and remote formats, hypothesizing that perceptions would not differ following remote delivery., Methods: 24 women with overweight or obesity (34.6±4.1 kg/m2, 48.2±9.9 years) received a 12-week Iyengar yoga intervention (2x/week) following a 3-month behavioral weight loss program. Of 23 participants who completed follow-up questionnaires, 12 received the planned in-person intervention and 11 received a remote intervention (delivered live) due to the COVID-19 pandemic. The Essential Properties of Yoga Questionnaire (EPYQ) was completed online by participants and by the instructors to measure the perceptions of the relative emphasis placed on the essential components of the yoga intervention via 14 subscales. Linear regression models were used to compare perceptions of each EPYQ dimension across in-person and remote delivery methods, as well as between participants and instructors, independent of delivery method., Results: 13 of the 14 subscales did not differ between delivery modalities (p>0.05). Participants perceived more individual attention within in-person yoga (p = 0.003). For both delivery methods, instructors perceived breathwork, restorative postures, and body locks to be incorporated to a lesser degree compared to participants (β = -1.28, p = 0.003; β = -1.57, p = 0.019; β = -1.39, p = 0.036; respectively). No other significant differences across the participant and instructor scores were observed., Conclusions: Findings provide preliminary support for the use of live remote delivery of yoga, effectively communicating most essential yoga properties when compared to in-person classes. However, participants perceived more individual attention with in-person versus remote delivery; thus, future remote-based yoga interventions may benefit from providing additional individualized feedback., Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: Dr. Unick is on the Scientific Advisory Board of Medifast. Dr. Sherman is an ambassador for lululemon. All remaining authors have no conflicts of interest to disclose. This does not alter our adherence to PLOS ONE policies on sharing data and materials., (Copyright: © 2024 Sherman et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objectives: Research on the association between hair concerns and physical activity (PA) constructs among African American (AA) women is lacking. Demographics such as age and income are indicated to influence hair concerns. In this study, quantitative methods were used to assess demographic differences in hair concerns and associations between hair concerns and PA. Qualitative interviewing explored AA women's views about their hair and engagement in PA., Methods: Participants (n = 48; M age = 37.57, SD = 13.72) completed a survey that included demographics, hair type and hairstyle management (HTHM), decisional balance (pros, cons), perceived benefits and perceived barriers scale, and level of physical activity. HTHM consists of six items measuring different factors related to hair concerns. 25 completed a qualitative interview. Chi-square or analysis of variance tests were conducted as appropriate. Qualitative data were analyzed using content analysis., Results: Proportion differences were noted between age groups (≤ 32 vs. ≥ 33) and average cost of haircare per month (p = .048). A statistically significant effect was noted for average monthly haircare cost and pros (p = .05), and for alter behavior due to hair concerns and perceived benefits to physical activity (p = .05). For level of physical activity, proportion differences were noted between exercisers and non-exercisers for average minutes spent on hair care (p = .009). Qualitative results showed few participants view hair concern as an important barrier to PA. Some participants suggested strategies for overcoming hair concerns to exercise (e.g., braids, twists)., Conclusion: Implications of findings including development of PA intervention approaches that may appeal to AA women are discussed., (© 2023. W. Montague Cobb-NMA Health Institute.)

Background: Individuals with mobility impairments (MI; use equipment to ambulate) have a high prevalence of both smoking and depression. Behavioral activation (BA) purports that depressed mood is remediated through valued activity engagement and may facilitate smoking cessation in MI populations., Objective: We examined cross-sectional associations between activity engagement and variables important for smoking cessation among a high-risk group of smokers (people with MIs) and also describe a smoking cessation intervention based on BA, given the lack of studies on smokers with MIs., Methods: This study used data from a smoking cessation trial enrolling smokers with MIs (n = 263). We assessed valued activities, activity type, activity restriction due to MI, and replacement of restricted activities. Motivation and confidence to quit smoking, number of cigarettes per day, and mood were also assessed. Analysis was performed with generalized linear (or logistic) regression models adjusted for age and physical functioning using aggregated data at baseline., Results: Greater number and frequency of valued activities was associated with less smoking, depression, negative affect, and stress and higher positive affect and self-efficacy to quit. Activity restriction was associated with greater odds of major depression, and activity replacement with lower odds of major depression, lower stress, and higher positive affect and self-efficacy. Strength of associations varied by activity type., Conclusions: Consistent with our theoretical model, BA activity constructs were associated with several mediators of smoking outcomes in the expected directions. Smokers engaging in valued activities have more favorable profiles for smoking cessation and mood management., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Background: Approximately 400,000 people who smoke cigarettes survive Acute Coronary Syndrome (ACS; unstable angina, ST and non-ST elevation myocardial infarction) each year in the US. Continued smoking following ACS is an independent predictor of mortality. Depressed mood post-ACS is also predictive of mortality, and smokers with depressed mood are less likely to abstain from smoking following an ACS. A single, integrated treatment targeting depressed mood and smoking could be effective in reducing post-ACS mortality., Method/design: The overall aim of the current study is to conduct a fully powered efficacy trial enrolling 324 smokers with ACS and randomizing them to 12 weeks of an integrated smoking cessation and mood management treatment [Behavioral Activation Treatment for Cardiac Smokers (BAT-CS)] or control (smoking cessation and general health education). Both groups will be offered 8 weeks of the nicotine patch if medically cleared. Counseling in both arms will be provided by tobacco treatment specialists. Follow-up assessments will be conducted at end-of-treatment (12-weeks) and 6, 9, and 12 months after hospital discharge. We will track major adverse cardiac events and all-cause mortality for 36 months post-discharge. Primary outcomes are depressed mood and biochemically validated 7-day point prevalence abstinence from smoking over 12 months., Discussion: Results of this study will inform smoking cessation treatments post-ACS and provide unique data on the impact of depressed mood on success of post-ACS health behavior change attempts., Trial Registration: ClinicalTrials.gov, NCT03413423. Registered 29 January 2018. https://beta., Clinicaltrials: gov/study/NCT03413423 ., (© 2023. The Author(s).)

Background: Dietary lapses can hinder weight loss and yoga can improve self-regulation, which may protect against lapses. This study examined the effect of yoga on dietary lapses, potential lapse triggers (e.g., affective states, cravings, dietary temptations), and reasons for initiating eating following weight loss treatment., Methods: Sixty women with overweight/obesity (34.3 ± 3.9 kg/m 2 ) were randomized to a 12 week yoga intervention (2x/week; YOGA) or contact-matched control (cooking/nutrition classes; CON) following a 12-week behavioral weight loss program. Participants responded to smartphone surveys (5x/day) over a 10-day period at baseline, 12, and 24 weeks to assess lapses and triggers., Results: At 24 weeks, YOGA and CON differed on several types of lapses (i.e., less eating past full, eating more than usual, loss of control when eating, self-identified overeating, difficulty stopping eating in YOGA), and YOGA was less likely to eat to feel better or in response to stress (ps < 0.05). YOGA also reported less stress and anxiety and more positive affect (ps < 0.01); dietary temptations and cravings did not differ from CON., Conclusion: Yoga resulted in fewer dietary lapses and improved affect among women with overweight/obesity following weight loss. While preliminary, findings suggest that yoga should be considered as a potential component of weight loss treatment to target dietary lapses., Competing Interests: Dr. Unick is on the Scientific Advisory Board of Medifast, Dr. Sherman is an ambassador for lululemon, and Dr. Wing is on the Scientific Advisory Board of Noom. All remaining authors have no conflicts of interest to disclose., (© 2023 The Authors. Obesity Science & Practice published by World Obesity and The Obesity Society and John Wiley & Sons Ltd.)

Introduction: There is evidence that Yoga may be helpful as an aid for smoking cessation. Yoga has been shown to reduce stress and negative mood and may aid weight control, all of which have proven to be barriers to quitting smoking. This study is the first rigorous, randomized clinical trial of Yoga as a complementary therapy for smokers attempting to quit., Methods: Adult smokers (N = 227; 55.5% women) were randomized to an 8-week program of cognitive-behavioral smoking cessation and either twice-weekly Iyengar Yoga or general Wellness classes (control). Assessments included cotinine-verified 7-day point prevalence abstinence at week 8, 3-month, and 6-month follow-ups., Results: At baseline, participants' mean age was 46.2 (SD = 12.0) years and smoking rate was 17.3 (SD = 7.6) cigarettes/day. Longitudinally adjusted models of abstinence outcomes demonstrated significant group effects favoring Yoga. Yoga participants had 37% greater odds of achieving abstinence than Wellness participants at the end of treatment (EOT). Lower baseline smoking rates (≤10 cigarettes/day) were also associated with higher likelihood of quitting if given Yoga versus Wellness (OR = 2.43, 95% CI = 1.09% to 6.30%) classes at EOT. A significant dose effect was observed for Yoga (OR = 1.12, 95% CI = 1.09% to 1.26%), but not Wellness, such that each Yoga class attended increased quitting odds at EOT by 12%. Latent Class Modeling revealed a 4-class model of distinct quitting patterns among participants., Conclusions: Yoga appears to increase the odds of successful smoking abstinence, particularly among light smokers. Additional work is needed to identify predictors of quitting patterns and inform adjustments to therapy needed to achieve cessation and prevent relapse., Implications: This study adds to our knowledge of the types of physical activity that aid smoking cessation. Yoga increases the odds of successful smoking abstinence, and does so in a dose-response manner. This study also revealed four distinct patterns of smoking behavior among participants relevant to quitting smoking. Additional work is needed to determine whether variables that are predictive of these quitting patterns can be identified, which might suggest modifications to therapy for those who are unable to quit., (© The Author(s) 2018. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Aims: Physical activity plays an important role in blood glucose management, yet most adults with elevated blood glucose do not engage in regular physical activity. Exercise videogames (EVGs) may be an attractive alternative for persons who have not found standard exercise modalities appealing., Methods: This sub-study within a larger trial examined the effects of 12 weeks of EVGs versus standard exercise (e.g., treadmill, cycling) and a control condition among individuals with elevated HbA1c (100% prediabetic). This study was conducted at a university research lab. Outcomes included HbA1c and weekly minutes of moderate to vigorous physical activity (MVPA) assessed using self-report and accelerometer.Other health risk indices (e.g., lipids) and psychosocial constructs shown to influence exercise participation (e.g., intrinsic motivation) were assessed., Results: Participants (n = 84), averaged age 51.4 years (range 20-79), 80% were female, and 77.4% were non-Hispanic. Baseline HbA1c ranged from 5.7% to 6.4% (39-49 mmol/mol). At week 12, EVG participants demonstrated an average 2% reduction in HbA1c compared to a 0.6% reduction in Standard and Control groups (p's = 0.04 and 0.03). EVG participants engaged in significantly more MVPA than Standard (+17 min/week) and Controls (+54 min/week) (p's < 0.05), had reduced LDL cholesterol (p = 0.05) and trends suggesting reduced body fat (p = 0.10). EVG participants reported higher exercise enjoyment and motivation compared to other participants., Conclusions: EVGs may be an attractive and effective tool to improve management of blood glucose that might contribute toward preventing the onset of type 2 diabetes among those with prediabetes., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Introduction: Smoking cessation interventions delivered through mobile technologies offer promise as an effective intervention tool. However, most existing programs have not been empirically tested, were not developed with end-user participation, and/or do not address evidence-based cognitive and behavioral variables shown to enhance smoking cessation in clinical trials. In addition, many programs tested in research trials have required users to access the internet and/or a smartphone app to access all program features, limiting the potential reach of those programs., Methods/design: This study is a randomized controlled trial testing the efficacy of the TMQ intervention for smoking cessation. All participants are randomly assigned to receive 12 weeks of either; (1) a tailored smoking-cessation intervention delivered 100% through text messaging (TMQ), or (2) non-smoking-related text messages serving as a control for contact and subject burden (Mojo). Assessments are conducted at baseline, 3- and 6-month follow-up. The primary outcome is prolonged abstinence using an intent-to-treat approach. To understand why TMQ may be more effective than Mojo, we will test several posited mechanisms of action (i.e., mediators) that may underlie intervention efficacy and will examine use of the TMQ integrated social support (ISS) network. At the end of treatment, semi-structured interviews will be conducted with TMQ participants., Conclusions: This study will provide a rigorous test of an innovative smoking cessation program delivered 100% through text messages. Use of mixed methodologies will provide the opportunity to enhance our understanding of the user's experience with TMQ and identify areas for future enhancement and/or expansion., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Introduction: Adults who engage in regular physical activity have lower rates of morbidity and mortality than those who do not. Exercise videogames may offer an attractive, sustainable alternative or supplement to traditional modes of exercise. This study compared exercise videogames with standard exercise modalities for improving uptake and maintenance of moderate to vigorous physical activity, and health risk indices., Study Design: A three-arm clinical RCT including 12 weeks of supervised laboratory-based moderate to vigorous physical activity followed by 6 months follow-up., Setting/participants: This study was conducted at a university affiliated hospital research lab. Healthy, sedentary adults were eligible., Interventions: This study compared a 12-week program of supervised exercise videogames versus standard exercise (e.g., treadmill) versus control. Data were collected from January 2012 to September 2017 and analyzed in 2018., Main Outcome Measures: The primary outcome was weekly minutes of moderate to vigorous physical activity at end of treatment, assessed at 3 and 6 months post-intervention by using self-report and accelerometer data. Health risk indices (e.g., HbA1c, lipids) were also assessed., Results: Participants (N=283) had an average age of 46.2 ±13.5 years; 79% were female. At end of treatment, those in the exercise videogame arm engaged in 30 minutes/week more moderate to vigorous physical activity compared with standard exercise and 85 more minutes/week than controls (all p<0.05). Exercise videogame participants had greater reductions in cholesterol, HbA1c, and body fat versus other groups. Reductions in cholesterol were twice as large in exercise videogame versus standard participants., Conclusions: Exercise videogames produced greater uptake and maintenance of moderate to vigorous physical activity compared with standard exercise and improvements in multiple health risk indices. Exercise videogames may promote sustainable physical activity with significant health benefits., Trial Registration: This study is registered at www.clinicaltrials.gov NCT03298919., (Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)

Spanish-speaking Latinas have some of the lowest rates of meeting physical activity guidelines in the U.S. and are at high risk for many related chronic diseases. The purpose of the current study was to examine the maintenance of a culturally and individually-tailored Internet-based physical activity intervention for Spanish-speaking Latinas. Inactive Latinas (N  =  205) were randomly assigned to a 6-month Tailored Physical Activity Internet Intervention or a Wellness Contact Control Internet Group, with a 6-month follow-up. Maintenance was measured by assessing group differences in minutes per week of self-reported and accelerometer measured moderate to vigorous physical activity (MVPA) at 12 months after baseline and changes in MVPA between the end of the active intervention (month 6) and the end of the study (month 12). Potential moderators of the intervention were also examined. Data were collected between 2011 and 2014, and were analyzed in 2015 at the University of California, San Diego. The Intervention Group engaged in significantly more minutes of MVPA per week than the Control Group at the end of the maintenance period for both self-reported (mean diff. = 30.68, SE = 11.27, p = .007) and accelerometer measured (mean diff. = 11.47, SE = 3.19, p = .01) MVPA. There were no significant between- or within-group changes in MVPA from month 6 to 12. Greater intervention effects were seen for those with lower BMI (BMI × intervention = -6.67, SE = 2.88, p = .02) and lower perceived places to walk to in their neighborhood (access × intervention = -43.25, SE = 19.07, p = .02), with a trend for less family support (social support × intervention = -3.49, SE = 2.05, p = .08). Acculturation, health literacy, and physical activity related psychosocial variables were not significant moderators of the intervention effect during the maintenance period. Findings from the current study support the efficacy of an Internet-delivered individually tailored intervention for maintenance of MVPA gains over time.

Background: Existing instruments that assess individuals' relationships with mobile phones tend to focus on negative constructs such as addiction or dependence, and appear to assume that high mobile phone use reflects pathology. Mobile phones can be beneficial for health behavior change, disease management, work productivity, and social connections, so there is a need for an instrument that provides a more balanced assessment of the various aspects of individuals' relationships with mobile phones., Objective: The purpose of this research was to develop, revise, and validate the Mobile Phone Affinity Scale, a multi-scale instrument designed to assess key factors associated with mobile phone use., Methods: Participants (N=1058, mean age 33) were recruited from Amazon Mechanical Turk between March and April of 2016 to complete a survey that assessed participants' mobile phone attitudes and use, anxious and depressive symptoms, and resilience., Results: Confirmatory factor analysis supported a 6-factor model. The final measure consisted of 24 items, with 4 items on each of 6 factors: Connectedness, Productivity, Empowerment, Anxious Attachment, Addiction, and Continuous Use. The subscales demonstrated strong internal consistency (Cronbach alpha range=0.76-0.88, mean 0.83), and high item factor loadings (range=0.57-0.87, mean 0.75). Tests for validity further demonstrated support for the individual subscales., Conclusions: Mobile phone affinity may have an important impact in the development and effectiveness of mobile health interventions, and continued research is needed to assess its predictive ability in health behavior change interventions delivered via mobile phones., Competing Interests: Conflicts of Interest: None declared., (©Beth C Bock, Ryan Lantini, Herpreet Thind, Kristen Walaska, Rochelle K Rosen, Joseph L Fava, Nancy P Barnett, Lori AJ Scott-Sheldon. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 15.12.2016.)

Background: Students at community colleges comprise nearly half of all U.S. college students and show higher risk of heavy drinking and related consequences compared to students at 4-year colleges, but no alcohol safety programs currently target this population., Objective: To examine the feasibility, acceptability, and preliminary efficacy of an alcohol risk-reduction program delivered through text messaging designed for community college (CC) students., Methods: Heavy drinking adult CC students (N=60) were enrolled and randomly assigned to the six-week active intervention (Text Message Alcohol Program: TMAP) or a control condition of general motivational (not alcohol related) text messages. TMAP text messages consisted of alcohol facts, strategies to limit alcohol use and related risks, and motivational messages. Assessments were conducted at baseline, week 6 (end of treatment) and week 12 (follow up)., Results: Most participants (87%) completed all follow up assessments. Intervention messages received an average rating of 6.8 (SD=1.5) on a 10-point scale. At week six, TMAP participants were less likely than controls to report heavy drinking and negative alcohol consequences. The TMAP group also showed significant increases in self-efficacy to resist drinking in high risk situations between baseline and week six, with no such increase among controls. Results were maintained through the week 12 follow up., Conclusions: The TMAP alcohol risk reduction program was feasible and highly acceptable indicated by high retention rates through the final follow up assessment and good ratings for the text message content. Reductions in multiple outcomes provide positive indications of intervention efficacy., (Copyright © 2016. Published by Elsevier Ltd.)

Background: Tobacco use is one of the leading preventable global health problems producing nearly 6 million smoking-related deaths per year. Interventions delivered via text messaging (short message service, SMS) may increase access to educational and support services that promote smoking cessation across diverse populations., Objective: The purpose of this meta-analysis is to (1) evaluate the efficacy of text messaging interventions on smoking outcomes, (2) determine the robustness of the evidence, and (3) identify moderators of intervention efficacy., Methods: Electronic bibliographic databases were searched for records with relevant key terms. Studies were included if they used a randomized controlled trial (RCT) to examine a text messaging intervention focusing on smoking cessation. Raters coded sample and design characteristics, and intervention content. Summary effect sizes, using random-effects models, were calculated and potential moderators were examined., Results: The meta-analysis included 20 manuscripts with 22 interventions (N=15,593; 8128 (54%) women; mean age=29) from 10 countries. Smokers who received a text messaging intervention were more likely to abstain from smoking relative to controls across a number of measures of smoking abstinence including 7-day point prevalence (odds ratio (OR)=1.38, 95% confidence interval (CI)=1.22, 1.55, k=16) and continuous abstinence (OR=1.63, 95% CI=1.19, 2.24, k=7). Text messaging interventions were also more successful in reducing cigarette consumption relative to controls (d+=0.14, 95% CI=0.05, 0.23, k=9). The effect size estimates were biased when participants who were lost to follow-up were excluded from the analyses. Cumulative meta-analysis using the 18 studies (k=19) measuring abstinence revealed that the benefits of using text message interventions were established only after only five RCTs (k=5) involving 8383 smokers (OR=1.39, 95% CI=1.15, 1.67, P<.001). The inclusion of the subsequent 13 RCTs (k=14) with 6870 smokers did not change the established efficacy of text message interventions for smoking abstinence (OR=1.37, 95% CI=1.25, 1.51, P<.001). Smoking abstinence rates were stronger when text messaging interventions (1) were conducted in Asia, North America, or Europe, (2) sampled fewer women, and (3) recruited participants via the Internet., Conclusions: The evidence for the efficacy of text messaging interventions to reduce smoking behavior is well-established. Using text messaging to support quitting behavior, and ultimately long-term smoking abstinence, should be a public health priority.

Background: More than 30% of the U.S. population is prehypertensive, and the recommended treatment of lifestyle modification includes increased physical activity. Exercise videogames (EVG) are widely marketed to Americans as a means of increasing fitness. This study aimed to examine EVG among a sample of prehypertensive adults, to determine (1) feasibility and acceptability of EVG for physical activity, and (2) assess changes in (1) estimates of cardiovascular fitness and risk indices, and psychosocial constructs., Methods: Participants with prehypertension completed a 12-week program including; 36, 1-hour sessions; supervised EVG program using Nintendo Wii platform and games. Assessments were at baseline and 13 weeks. Paired t-tests were conducted., Results: Fourteen adults (84% female; mean age=53 years; 93% Caucasian; 87% employed) completed the study. The study retention rate was 74% and all participants reported satisfaction and enjoyment in the intervention and using the Wii for exercise. Despite the small sample size, significant improvements were seen in: physical activity minutes (P<0.01), peak heart rate (P=0.02), resting systolic blood pressure (P=0.02), and hip circumference (P=0.03). Significant improvements were also seen in the 36-item short-form survey (SF-36) as for general health (P=0.05), role limitations due to emotional problems (P=0.04), and vitality (P=0.01)., Conclusions: Findings support that an EVG program is feasible, acceptable, and promising in promoting benefit to cardiovascular fitness and psychosocial health. These data provide pilot data for the necessary randomized clinical trials to examine efficacy and sustainability of EVG for adult engagement in physical activity for cardiovascular health promotion.

Existing instruments that assess the individual's relationship with technology tend to focus on negative constructs and assume that a high use of technology reflects pathology. Since technology use can be beneficial, there is a need for a more balanced instrument. An initial survey to assess the individual's relationship with their mobile phone was developed, checked for face validity and the resulting survey was administered online to students at local colleges. 146 adults (mean age=25.5 years) completed surveys. Principal Component Analysis with varimax rotation produced a final 27-item scale with factor loadings from .50 to .81, representing 4 components: "Usefulness", "Anxious Attachment", "Addiction" and "24/7" (continuous use). This study produced an instrument to assess multiple aspects of the individuals' relationship to their mobile phone. Additional work is needed to validate this measure in other populations, with larger samples, and to assess its predictive ability in mHealth interventions delivered through mobile phones.

This study compares the characteristics of men and women, respectively, participating in two randomized controlled pilot studies whose primary aims were to test the feasibility of yoga as a complementary therapy for smoking cessation. Participants were aged 18-65, generally healthy and were daily smokers. Analysis of variance (ANOVA) and chi-square tests examined gender differences in smoking rate, potential treatment mediators, and covariates (e.g., smoking history, health status, weight concerns, mood, and prior withdrawal symptoms). A total of 55 women and 38 men participated in the study. Differences between men and women at enrollment included: women reported significantly greater withdrawal (p<0.005), anxiety (p=0.032), and depression (p=0.027) symptoms than men. More women than men (91% vs . 66%) reported having been told by their doctor to quit smoking (p=0.003), had an existing smoking-related illness (33% vs . 13%; p=0.032), and reported smoking for weight control (15% vs . 0%; p=0.014). Results showed good feasibility for recruiting both men and women into a study using yoga as a complementary therapy for smoking cessation. Results also indicate that interventions may need to be tailored to meet different needs (e.g., addressing co-morbid depression) between men and women.

Innovative treatments like yoga for men's smoking cessation (SC) are lacking. To examine the feasibility and acceptability of yoga for men's SC. We randomly assigned eligible men (smoker, ≥5 cigarettes/day, age 18-65) to receive cognitive behavioral therapy for SC, plus a yoga or wellness program. Measures included feasibility (recruitment, class attendance) and acceptability (customer satisfaction). We enrolled 38 of 49 eligible men of 167 screened in response to ads (mean age 39.9 years, ±13.7) who smoked on average 18.6 cigarettes/day (±8.3). Wellness (75.8 %) versus yoga (56 %) men attended more SC classes, p < 0.01. Sixty percent attended ≥1 yoga class. Men reported greater satisfaction with in-house versus community yoga classes. Wellness appears to be the preferred intervention; results indicated that it may be more feasible and showed increased attendance at smoking classes. To be fully feasible, yoga + SC may need to be a unified program offering all classes tailored for men and in the same location.

Introduction: Despite numerous health benefits, less than half of American adults engage in regular physical activity. Exercise videogames (EVG) may be a practical and attractive alternative to traditional forms of exercise. However there is insufficient research to determine whether EVG play alone is sufficient to produce prolonged engagement in physical activity or improvements in cardiovascular fitness and overall health risk. The goal of the present study is to test the efficacy of exercise videogames to increase time spent in moderate to vigorous physical activity (MVPA) and to improve cardiovascular risk indices among adults., Methods: Wii Heart Fitness is a rigorous 3-arm randomized controlled trial with adults comparing three 12-week programs: (1) supervised EVGs, (2) supervised standard exercise, and (3) a control condition. Heart rate is monitored continuously throughout all exercise sessions. Assessments are conducted at baseline, end of intervention (week 12), 6 and 9 months. The primary outcome is time spent in MVPA physical activity. Secondary outcomes include changes in cardiovascular fitness, body composition, blood lipid profiles and maintenance of physical activity through six months post-treatment. Changes in cognitive and affective constructs derived from Self Determination and Social Cognitive Theories will be examined to explain the differential outcomes between the two active treatment conditions., Conclusion: The Wii Heart Fitness study is designed to test whether regular participation in EVGs can be an adequate source of physical activity for adults. This study will produce new data on the effect of EVGs on cardiovascular fitness indices and prolonged engagement with physical activity., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Background: Tobacco use among prisoners is much higher than among the general population. Little is known about changes in smoking-related symptoms during periods of incarceration. The objective of this study is to evaluate changes in smoking-related symptoms during incarceration., Methods: We recruited 262 inmates from a tobacco-free prison. At baseline, participants were asked about smoking-related symptoms prior to incarceration and then asked about recent symptoms., Results: All symptom scores on the American Thoracic Society Questionnaire (ATSQ) improved during incarceration. Higher ATSQ scores were associated with asthma, depressive symptoms, stress, higher addiction and more pack years of smoking. Greater improvement in symptoms was not associated with smoking status after release., Conclusion: Forced tobacco abstinence leads to significant improvements in smoking-related symptoms. However, improvements in symptoms are not associated with smoking behavior changes. Addressing changes in symptoms during incarceration will require further evaluation in smoking cessation interventions for incarcerated populations.

Introduction: Smokers trying to quit encounter many challenges including nicotine withdrawal symptoms, cigarette craving, increased stress and negative mood and concern regarding weight gain. These phenomena make it difficult to successfully quit smoking. Studies in non-smoking populations show that yoga reduces stress and negative mood and improves weight control. By increasing mindfulness we anticipate that yoga may also improve smokers' ability to cope with the negative symptoms associated with quitting. Yoga may also improve cognitive deliberation which is needed to make effective choices and avoid smoking in tempting situations., Methods/design: The BreathEasy study is a rigorous, randomized controlled clinical trial examining the efficacy of Iyengar yoga as a complementary therapy to cognitive-behavioral therapy for smoking cessation. All participants are given an 8-week program of smoking cessation classes, and are randomized to either twice weekly yoga (Yoga) or twice-weekly health and wellness classes which serve as a control for contact and participant burden (CTL). Assessments are conducted at baseline, 8 weeks, 3, 6, and 12 months of follow-up. The primary outcome is prolonged abstinence using an intention-to-treat approach. Multiple internal and external audits using blind data collection are employed to ensure treatment fidelity and reliability of study results. To understand why yoga may be more effective than CTL, we will examine the mechanisms of action (i.e., mediators) underlying intervention efficacy. We will examine the maintenance of yoga practice and smoking status at each follow-up. Focus groups and interviews will be used to enrich our understanding of the relationship of yoga practice and smoking abstinence., Conclusions: This study will provide a stringent test of the relative efficacy of yoga compared to a condition that controls for contact time and attention. The use of mixed methodology also provides the opportunity to validate existing knowledge about yoga and helps to explore new themes for future mindfulness and yoga research., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Introduction: Despite decades of tobacco use decline among the general population in the United States, tobacco use among low-income populations continues to be a major public health concern. Smoking rates are higher among individuals with less than a high school education, those with no health insurance, and among individuals living below the federal poverty level. Despite these disparities, smoking cessation treatments for low-income populations have not been extensively tested. In the current study, the efficacy of 2 adjunctive smoking cessation interventions was evaluated among low-income smokers who were seen in a primary care setting., Methods: A total of 846 participants were randomly assigned either to motivational enhancement treatment plus brief physician advice and 8 weeks of nicotine replacement therapy (NRT) or to standard care, which consisted of brief physician advice and 8 weeks of NRT. Tobacco smoking abstinence was at 1, 2, 6, and 12 months following baseline., Results: The use of the nicotine patch, telephone counseling, and positive decisional balance were predictive of increased abstinence rates, and elevated stress levels and temptation to smoke in both social/habit and negative affect situations decreased abstinence rates across time. Analyses showed intervention effects on smoking temptations, length of patch use, and number of telephone contacts. Direct intervention effects on abstinence rates were not significant, after adjusting for model predictors and selection bias due to perirandomization attrition., Conclusions: Integrating therapeutic approaches that promote use of and adherence to medications for quitting smoking and that target stress management and reducing negative affect may enhance smoking cessation among low-income smokers.

Younger adults are more likely to smoke and less likely to seek treatment than older smokers. They are also frequent users of communication technology. In the current study, we conducted focus groups to obtain feedback about preferences for a text message-based smoking cessation program from potential users. Participants (N = 21, M age = 25.6 years, age range = 20-33 years) were current or recently quit smokers (M cigarettes/day = 12.8) who used text messaging. Participants completed questionnaires and participated in a 2-hour focus group. Focus groups were conducted using an a priori semistructured interview guide to promote discussion of the content and functionality of the intervention. Major themes from analysis of the focus groups included support for the acceptability of a text-based cessation program, suggestions for a more technologically broad-based program, and adjustments to the program structure. Participants recommended including social networking functions, user control of program output through an online profile, and text message features to promote interaction with the system. Interestingly, many participants suggested the program should begin on individuals' identified quit day, challenging the procedures used in most cessation programs, which begin by preparing participants for a future quit date. Overall, younger adult smokers appear to be interested in participating in a smoking cessation program that uses text messages and web-based elements. Qualitative feedback regarding the perceived optimal features and structure of a technology-based intervention challenged traditional methods of implementing smoking cessation interventions and will inform the development of future programs.

Introduction: Pharmacists are uniquely positioned within the community to provide smoking cessation counseling to their patients. However, pharmacists experience significant barriers to providing counseling, including limited time, reimbursement, and training in counseling techniques. We tested a computer-driven software system, "Exper&#95;Quit" (EQ), that provided individually tailored interventions to patients who smoke and matching tailored reports for pharmacists to help guide cessation counseling., Methods: A two-phase design was used to recruit an observation-only group (OBS; n = 100), followed by participants (n = 200) randomly assigned to receive either EQ-assisted pharmacist counseling or EQ plus 8 weeks of nicotine transdermal patch (EQ+). Both treatment groups were scheduled to receive two follow-up counseling calls from pharmacists., Results: Most participants in the EQ and EQ+ groups reported receiving counseling from a pharmacist, including follow-up calls, while none of the OBS participants reported speaking with the pharmacist about cessation. At 6 months, fewer OBS participants reported a quit attempt (42%) compared with EQ (76%) or EQ+ (65%) participants (p < .02). At 6 months, 7-day point-prevalence abstinence was 28% and 15% among the EQ+ and EQ groups, respectively, compared with 8% among OBS participants (p < .01), and EQ+ participants were twice as likely to be quit than were EQ participants (p < .01)., Discussion: A tailored software system can facilitate the delivery of smoking cessation counseling to pharmacy patients. Results suggest that EQ was successful in increasing (a) the delivery of cessation counseling, (b) quit attempts, and (c) quit rates. Pharmacists can play an important role in the effective delivery of smoking cessation counseling.