Classification of smoking cessation status with a backpropagation neural network

This study examined the ability of a backpropagation neural network (BPNN) classifier to distinguish between current and former smokers in the 2000 National Health Interview Survey (NHIS) sample adult file. The BPNN classifier performance exceeded that of random chance, with asymmetric 95% confidence intervals for A_z (area under receiver operating characteristic curve) = (0.7532, 0.7790). Separation of current and former smokers was imperfect, as illustrated by the receiver operating characteristic (ROC) curve. Additionally, performance did not exceed that of a comparison classifier created using logistic regression. Attribute subset selection identified three novel attributes related to smoking cessation status. This study establishes the ability of backpropagation neural networks to classify a complex health behavior, smoking cessation. It also illustrates the hypothesis-generating capacity of data mining methods when applied to large population-based health survey data. Ultimately, BPNN classifiers of smoking cessation status may be useful in decision support systems for smoking cessation interventions.     

Impact of spirometry feedback and brief motivational counseling on long-term smoking outcomes: A comparison of smokers with and without lung impairment

Objective

We compared long-term outcomes among smokers with and without impaired lung functioning who received brief counseling highlighting their spirometric test results.

Methods

Participants in this analysis all received a brief motivational intervention for smoking cessation including spirometric testing and feedback (∼20 min), were advised to quit smoking, offered free access to a phone-based smoking cessation program, and followed for one year. Outcomes were analyzed for smokers with (n = 99) and without (n = 168) impaired lung function.

Results

Participants with lung impairment reported greater use of self-help cessation materials at 6 months, greater use of non-study-provided counseling services at 6 and 12 months, higher 7-day PPA rates at 6 months, and were more likely to talk with their doctor about their spirometry results.

Conclusion

Further research is warranted to determine if spirometry feedback has a differential treatment effect among smokers with and without lung impairment.

Practice implications

It is premature to make practice recommendations based on these data.     

Psychosocial and behavioral outcomes in children with sickle cell disease and their healthy siblings

The current study aims to compare positive and negative measures of psychosocial functioning among children with sickle cell disease (SCD) and their healthy siblings. Participants were 41 African-American children with SCD, 97 healthy siblings, and their primary caregivers. Primary caregivers completed self-report questionnaires assessing child behavioral problems, while children with SCD and siblings completed self-report questionnaires assessing coping, self-efficacy, and perceived social support. No significant differences were noted between children with SCD and their siblings on all measures. Both groups reported self-efficacy and perceived social support within the normative range, and endorsed significantly greater use of Positive/Approach coping. In general, both groups of children do not have clinically significant behavioral problems. However, secondary exploratory analyses identified that a greater percentage of children from both groups scored above the established clinical cutoff on the behavioral summary scores. Number of visits to the emergency room was related to behavioral problems in children with SCD. While previous reports have been mixed in their findings that children with SCD are at greater risk for psychosocial and other behavioral problems, the current report finds that children with SCD and their healthy siblings endorse positive psychosocial functioning and as a group do not have clinically significant behavioral problems. Nonetheless, ongoing psychosocial evaluation for children receiving treatment for SCD is vital.     

Health status, adherence with health recommendations, self-efficacy and social support in patients with rheumatoid arthritis

A study was performed in 86 patients with rheumatoid arthritis (RA) to assess their health problems, the problems they experience in adhering to health recommendations and the relationships of these problems with self-efficacy and social support. Feeling dependent, disability and pain were the most important health related problems. The results showed self-efficacy to be related to the subjective experience of health status as measured by DUTCH-AIMS. Social emotional support was not related to health status and contrary to what we expected social instrumental support was positively related to health status. The majority of the patients (55%) experienced adherence problems with health recommendations. These problems were not related to functional incapacity, pain or other aspects of health status but to the patient's self-efficacy expectations about coping with arthritis. Our conclusion is that to improve the self-management of disability and pain and adherence to health recommendations, patient education should be aimed at strengthening self-efficacy expectations in which social emotional support might be a motivating factor.     

User preferences for and engagement with text messages to support antihypertensive medication adherence: Findings from a pilot study evaluating an emergency department-based behavioral intervention

ObjectiveWe examined users’ preferences for and engagement with text messages delivered as part of an emergency department (ED)-based intervention to improve antihypertensive medication adherence.MethodsWe recruited ED patients with elevated blood pressure for a pilot randomized trial evaluating a medication adherence intervention with text messages. Intervention participants chose text content and frequency, received texts for 45 days, and completed a feedback survey. We defined engagement via responses to texts. We examined participant characteristics associated with text preferences, engagement, and feedback.ResultsParticipants (N = 101) were 57% female and 46% non-White. Most participants (71%) chose to receive both reminder and informational texts; 94% chose reminder texts once per day and 97% chose informational texts three times per week. Median text message response rate was 56% (IQR 26–80%). Participants who were Black (p < 0.01), had lower income (p = 0.03), or had lower medication adherence (p < 0.01) rated the program as more helpful and wanted additional functionalities for adherence support.Conclusions and Practice ImplicationsWhile overall engagement was modest, participants at risk of worse health outcomes expressed more value and interest in the program. Findings inform the design of text messaging interventions for antihypertensive medication adherence and support targeting vulnerable patients to reduce health disparities.Clinical trials registrationNCT02672787     

The impact of a peer support group for children with rheumatic heart disease in Uganda

Objective

To assess the impact of a peer-support group on knowledge, quality of life, and social support for children with rheumatic heart disease (RHD).