Motivation rulers for smoking cessation: a prospective observational examination of construct and predictive validity

Boudreaux, Sullivan Ashley, Abar Beau, Bernstein, Ginde, Camargo

Description

Although popular clinically, the psychometric properties of motivation rulers for tobacco cessation are unknown. This study examined the psychometric properties of rulers assessing importance, readiness, and confidence in tobacco cessation. Methods This observational study of current smokers was conducted at 10 US emergency departments (EDs). Subjects were assessed during their ED visit (baseline) and reassessed two weeks later. We examined intercorrelations between the rulers as well as their construct and predictive validity. Hierarchical multinomial logistic regressions were used to examine the rulers’ predictive ability after controlling for covariables. Results We enrolled 375 subjects. The correlations between the three rulers ranged from 0.50 (between Important and Confidence) to 0.70 (between Readiness and Confidence); all were significant (p < 0.001). Individuals in the preparation stage displayed the highest motivation-ruler ratings (all rulers F 2, 363 ≥ 43; p < 0.001). After adjusting for covariables, each of the rulers significantly improved prediction of smoking behavior change. The strength of their predictive ability was on par with that of stage of change. Conclusion Our results provide preliminary support for the psychometric soundness of the importance, readiness, and confidence rulers.

Sujets

• Tobacco
• Smoking cessation
• Motivation
• Reliability
• Validity

Informations

• Publié par: biomed
• Publié le: 01 janvier 2012
• Nombre de lectures: 15
• Langue: English

Extrait

Boudreauxet al. Addiction Science & Clinical Practice2012,7:8 http://www.ascpjournal.org/content/7/1/8

R E S E A R C H

Open Access

Motivation rulers for smoking cessation: a prospective observational examination of construct and predictive validity 1* 2 1 3 4 2 Edwin D Boudreaux , Ashley Sullivan , Beau Abar , Steven L Bernstein , Adit A Ginde and Carlos A Camargo Jr.

Abstract Background:Although popular clinically, the psychometric properties of motivation rulers for tobacco cessation are unknown. This study examined the psychometric properties of rulers assessing importance, readiness, and confidence in tobacco cessation. Methods:This observational study of current smokers was conducted at 10 US emergency departments (EDs). Subjects were assessed during their ED visit (baseline) and reassessed two weeks later. We examined intercorrelations between the rulers as well as their construct and predictive validity. Hierarchical multinomial logistic regressions were used to examine the rulers’predictive ability after controlling for covariables. Results:We enrolled 375 subjects. The correlations between the three rulers ranged from 0.50 (between Important and Confidence) to 0.70 (between Readiness and Confidence); all were significant (p<0.001). Individuals in the preparation stage displayed the highest motivationruler ratings (all rulers F 2, 363 ≥43; p<0.001). After adjusting for covariables, each of the rulers significantly improved prediction of smoking behavior change. The strength of their predictive ability was on par with that of stage of change. Conclusion:Our results provide preliminary support for the psychometric soundness of the importance, readiness, and confidence rulers. Keywords:Tobacco, Tobacco cessation, Motivation, Stage of change, Reliability, Validity

Introduction The construct of motivational readiness to change is fundamental to many health behavior theories, and it lies at the heart of numerous therapeutic approaches. For example, motivational interviewing [1] (MI) focuses on enhancing internal motivation to change a behavior and emphasizes that, when strong internal motivation is present, behavior change is more likely to occur and to persist. Motivational interviewing and other types of brief intervention (BI) derived from it have enjoyed con- siderable empirical support across a range of settings,

* Correspondence: [e-mail] 1 Departments of Emergency Medicine, Psychiatry, and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA 01655, USA Full list of author information is available at the end of the article

study samples, and target behaviors [1,2] and have been successfully applied to smoking cessation [3-6]. The practical application of MI in clinical settings (as well as interventions derived from other health behavior theories such as the transtheoretical model [7]) typically includes the regular assessment of motivation. Motiv- ational assessments can help clinicians tailor the thera- peutic approach, exercises, homework, duration, and resources used with an individual. Although clinicians working in specialized outpatient settings to treat tobacco use can use more comprehensive measures of motivation, clinicians working in medical settings, such as primary care clinics, hospitals, and EDs, require very short and rapid assessment tools. Assessments that can be con- densed to a few easy-to-understand questions and that can be re-administered over time while maintaining their reliability and validity are considered the most useful.

© 2012 Boudreaux et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.