Cost effectiveness of a community based research project to help women quit smoking.

Objective: To estimate the cost effectiveness of a four year, multifaceted, community based research project shown previously to help women quit smoking.

Design: A quasi-experimental matched control design.

Setting: Two counties in Vermont and two in New Hampshire, USA.

Factors associated with arm swelling after breast cancer surgery.

Purpose: As life expectancy improves for women with breast cancer, more women will be living with symptoms of lymphedema. This study reports the incidence of arm or hand swelling and associated risk factors in women with invasive breast cancer following surgery.

Methods: Data were obtained from baseline and follow-up interviews of women with invasive breast cancer (n = 145), and mammography and pathology records.

Factors influencing quality of life in breast cancer survivors.

Longitudinal data from 195 breast cancer survivors were used to identify factors affecting the level and rate of change in quality of life after completion of treatment. Women were interviewed up to four times at approximately yearly intervals using Kaplan and Bush's Quality of Well Being instrument (QWB). Random coefficient regression analysis was used to model QWB as a function of time since diagnosis and personal characteristics.

Relationships between cigarette smoking during pregnancy, gestational age, maternal weight gain, and infant birthweight.

Objective: To estimate the effect of smoking on infant birthweight independent of gestational age and maternal weight gain during pregnancy.

Methods: Stepwise regression was used to identify sets of maternal and infant characteristics not modified by prenatal smoking that were predictors of infant birthweight, gestational age, and net maternal weight gain. These were then included in regression analyses to assess the effects of smoking, as measured by cigarette consumption, exhaled carbon monoxide, or urinary cotinine on gestational age, net maternal weight gain, and infant birthweight.

Evaluation of a community breast screening promotion program.

Background: This study reports results of a controlled evaluation of a comprehensive community breast screening promotion program. This program promoted increased use of mammography, clinical breast examination, and breast self-examination through community organization, physician training, and public education.

Methods: The program was conducted in one of three matched Florida study areas, with before and after assessment of breast screening behaviors, beliefs, and perceptions of women ages 40 and older.

Infant birth weight as a measure of harm reduction during smoking cessation trials in pregnancy.

During pregnancy, a reduction of 50% or more of a biochemical measure of smoking, among continuing smokers, has been proposed by Windsor and colleagues as a new behavioral indicator of harm reduction because it was accompanied by greater infant birth weight compared with that of infants of smokers with lesser reductions. The purpose of the authors' study was to replicate these observations. During a trial of smoking cessation during pregnancy, data on cigarettes per day, urinary cotinine.

Community interventions for reducing smoking among adults.

Background: Since smoking behaviour is determined by social context, the best way to reduce the prevalence of smoking may be to use community-wide programmes which use multiple channels to provide reinforcement, support and norms for not smoking.

Objectives: To assess the effectiveness of community interventions for reducing the prevalence of smoking.

Search Strategy: We searched the Cochrane Tobacco Addiction Group specialised register, MEDLINE (1966-August 2001) and EMBASE (1980-August 2001) and reference lists of articles.

Impact of maternal cigarette smoking on fetal growth and body composition.

Objective: The aim of this study was to determine the impact of maternal cigarette smoking on the fetal accretion of fat and lean body mass. We hypothesized that maternal smoking would result in a reduction in the deposition of lean body mass.

Study Design: Longitudinal ultrasonographic examinations on 65 singleton fetuses without anomalies of smoking mothers were compared with 36 singleton fetuses without anomalies of nonsmoking mothers.

Free nicotine patches plus proactive telephone peer support to help low-income women stop smoking.

Background: This study tested the impact of free nicotine patches plus proactive telephone peer support to help low-income women stop smoking.

Methods: A total of 214 Medicaid-eligible women smokers of childbearing age were randomized to receive free nicotine patches through the mail or free nicotine patches through the mail plus the provision of proactive support by telephone from a woman ex-smoker for up to 3 months. Assessments were conducted by telephone at baseline, 10 days, and 3 and 6 months after enrollment.

Helping women quit smoking: results of a community intervention program.

Objectives: This intervention was implemented to reduce the prevalence of cigarette smoking among women.

Methods: We used community organization approaches to create coalitions and task forces to develop and implement a multicomponent intervention in 2 counties in Vermont and New Hampshire, with a special focus on providing support to help women quit smoking. Evaluation was by pre-intervention and post-intervention random-digit-dialed telephone surveys in the intervention counties and the 2 matched comparison counties.

The role of health professionals in a community-based program to help women quit smoking.

Background: Health professionals are credible sources of smoking cessation advice. This study describes changes in health professionals' reported provision of smoking cessation counseling activities for women during a community health education project that took place in two intervention counties (I) and compares these to reports from health professionals in two similar comparison counties (C).

Methods: Specific smoking cessation activities reported by physicians (I n = 73, C n = 73), dentists (I n = 51, C n = 46), dental hygienists (I n = 38, C n = 44), family planning and WIC (Special Supplemental Food Program for Women, Infants and Children) counselors (I n = 14 C n = 16), and community mental health counselors (I n = 57, C n = 23) were assessed by mailed surveys at baseline, after 4 years of countywide interventions, and 2 years later.

Life expectancy estimation with breast cancer: bias of the declining exponential function and an alternative to its use.

Background: Life expectancy gain (LEG) is an outcome measure commonly estimated with a declining exponential function in a Markov model. The accuracy of such estimates has not been objectively evaluated.

Purpose: To compare LEGs from declining exponential function estimates with those calculated from population data, using published screening mammography studies as examples.

Screening for breast cancer: time, travel, and out-of-pocket expenses.

Background: We estimated the personal costs to women found to have a breast problem (either breast cancer or benign breast disease) in terms of time spent, miles traveled, and cash payments made for detection, diagnosis, initial treatment, and follow-up.

Methods: We analyzed data from personal interviews with 465 women from four communities in Florida. These women were randomly selected from those with a recent breast biopsy (within 6-8 months) that indicated either breast cancer (208 women) or benign breast disease (257 women).

Estimated gains in birth weight associated with reductions in smoking during pregnancy.

Objective: To compare the estimated effect on birth weight of reductions in maternal cigarette consumption and urinary cotinine during pregnancy.

Study Design: An observational study of 641 women with complete data on cigarette consumption, urinary cotinine and infant birth weight. Correlation and regression analyses were used to examine relationships between birth weight, cigarette consumption and urinary cotinine at first and last prenatal visits.

Smoking relapse prevention during pregnancy. A trial of coordinated advice from physicians and individual counseling.

Introduction: Our objective was to examine the efficacy of physicians' advice and referral to individual counseling in preventing relapse to smoking among women who were smokers early in pregnancy, but quit prior to their first prenatal visit.

Design: A randomized controlled trial of prompted physician's advice and individual relapse prevention counseling during pregnancy compared to usual physician advice. Smoking status was assessed by self-report, exhaled carbon monoxide, and urinary cotinine during pregnancy and by self-report 1 year postpartum.

Reducing smoking during pregnancy and postpartum: physician's advice supported by individual counseling.

Background: Physicians' advice to help pregnant women quit smoking during prenatal care has had mixed results. Training and prompting physicians to provide consistent advice and referral to on-site support might improve cessation rates.

Methods: Pregnant women who smoked were randomly assigned to receive structured advice from their physician and referral to individual behavior change counseling during prenatal care or to receive brief advice to stop smoking and a quit smoking booklet at their first visit.

A Native American community initiative to prevent diabetes.

The increasing prevalence of obesity and diabetes in the Mohawk Community of Akwesasne led to the formation of an advisory group who's mission was to increase community awareness and strengthen the infrastructure necessary to create a community coalition to promote healthy lifestyles. The methodology used to reach these goals included: obtaining an understanding of the community's knowledge, attitudes and behaviors about diabetes, diet and exercise using semi-structured interviews and focus groups; analyzing data from a case control study of diabetes and it complications using a medical record review; exploring methods for evaluating energy expenditure in children; and identifying influential community members and organizations. In the last 50 years people had become less physically active and high fat, high caloric foods were more available.

A mass media programme to prevent smoking among adolescents: costs and cost effectiveness.

Objective: To examine costs and cost-effectiveness ratios of a four-year mass media programme previously shown to prevent the onset of smoking among adolescents.

Design: A matched control design.

Setting: Two cities in Montana, one in New York and one in Vermont, USA.

Exhaled carbon monoxide and urinary cotinine as measures of smoking in pregnancy.

We examined the relationships among self-reported cigarette consumption, exhaled carbon monoxide, and urinary cotinine/creatinine ratio in pregnant women. Information on these measures of smoking was collected at first and 36th week prenatal visits. Correlations between cigarette consumption and exhaled carbon monoxide were .

Food preferences predict eating behavior of very young Mohawk children.

Objective: To collect baseline data on energy and nutrient intake and nutrition knowledge, attitudes, and behavior of very young Mohawk children to assist the community in planning an appropriate, targeted nutrition and exercise intervention.

Design: Energy and nutrient intake data were collected from 24-hour recalls conducted in the children's homes. Nutrition knowledge, attitudes, and behavior were assessed using a 38-item questionnaire that asked children to report on what foods they like the best, eat most of the time, and think are healthful.