Development of a Contextually Tailored and Optimized Smoking Cessation Intervention for Homeless Youth

Youth's psychological and physical capacity (capability)

时间窗: Up to 3 years

Participant's psychological and physical capacity that have prompted them in the past or may motivate them to 1) smoke, 2) make a quit attempt, and 3) engage in supported cessation will be captured. An iterative approach to team-based codebook development and coding will be used to analyze interview data. In Stage 1, text will be coded according to the specific research question using structural codes. In Stage 2, in depth codes will be created using emergent themes from the structurally coded text. The coders will create as many in depth codes as needed in order to capture all aspects of youth's perspective on current psychosocial influences on smoking, and the psychological and physical capacities critical to engagement in tobacco cessation intervention. Data is separated by the age cut-off for standard recommendations regarding cessation intervention (14-17 and 18-24) to assess if differences exist that should be considered for intervention in homeless drop in centers.

Youth's physical and social factors (opportunity)

时间窗: Up to 3 years

Participant's physical and social factors (opportunity) that have prompted them in the past or may motivate them to 1) smoke, 2) make a quit attempt, and 3) engage in supported cessation will be captured. In Stage 1, text will be coded according to the specific research question using structural codes. In Stage 2, in depth codes will be created using emergent themes from the structurally coded text. The coders will create as many in depth codes as needed in order to capture all aspects of youth's perspective on current psychosocial influences on smoking, and the physical and social opportunities critical to engagement in tobacco cessation intervention. Data is separated by the age cut-off for standard recommendations regarding cessation intervention (14-17 and 18-24) to assess if differences exist that should be considered for intervention in homeless drop in centers.

Youth's Psychological and Physical Capacity

时间窗: 60 minute semi-structured interview

Factors associated with participant's psychological and physical capacity which have prompted them to smoke in the past were captured during semi-structured interviews. In-person interviews followed a semi-structured interview guide. Questions were grounded in the Capability-Opportunity-Motivation for Behavior model, a theoretical framework that describes how intersecting psychosocial and environmental factors influence behavior. Questions were designed to elicit data on factors influencing tobacco use at a specific moment in time (participants' "last smoke") with the intent to optimize supportive cessation interventions for this population.

Youth's Physical and Social Factors

时间窗: Approximately 90 minute interview

Coping with homelessness was assessed using the Brief COPE to examine strategies used for coping or regulating cognition in response to stressors; participants were specifically asked to focus on their housing situation. This measure includes 28 items combined to form 14 subscales. Scores on each subscale range from 2 to 8 with higher scores indicating greater use of the strategy.

Motivation to Quit

时间窗: Approximately 90 minute interview

Interest in quitting in the next 30 days is an exemplar Phase-Based Model (PBM) for Cessation Research motivation phase treatment outcome measure. Participants reported if and when they planned to quit, derived from, "Do you plan to quit for good?" and "When do you plan to quit for good? In the next (7 days, 30 days, 6 months, year, more than a year from now)."

Past Quit Attempts

时间窗: Approximately 90 minute interview

Number of past year quit attempts: a proxy for past willingness to quit. Participants reported the number of quit attempts in the past year: "In the past 12 months, how many times have you quit smoking for at least 24 hours in a serious attempt to quit?"

Confidence in Ability to Quit in Next 6 Months

时间窗: Approximately 90 minute interview

Confidence in ability to quit in the next 6 months was measured with: "If you did try quitting smoking altogether in the next 6 months, how likely do you think you would be to succeed - not at all, a little likely, somewhat likely or very likely?"

Motivations for Smoking

时间窗: Approximately 90 minute interview

The Tobacco Motives Inventory was used; 15 questions, each scored on a 5-point Likert scale, were combined into four sub-scales: social motives, self enhancement motives, boredom relief motives, and affect regulation motives. Higher scores on each sub-scale indicate a higher motivation to smoke. Social motives: Sum of 4 items, scores range from 4 to 20 Self enhancement motives: Sum of 4 items, scores range from 4 to 20 Boredom relief motives: Sum of 2 items, scores range from 2 to 10 Affect regulation motives: Sum of 5 items, scores range from 5 to 25

Rewards From Quitting Smoking

时间窗: Approximately 90 minute interview

We measured 15 different rewards from smoking: "What are the benefits of smoking to you? Check all that apply"