Stage versus continuum models for smoking cessation

描述(由申请者提供)：健康行为的阶段理论在过去20年里越来越流行。阶段模型之所以吸引人，是因为它们为原本复杂而笨拙的变量组合带来了结构和秩序。为了说明这一点，考虑一下预测戒烟的许多变量：吸烟率、过去的戒烟尝试以及尼古丁依赖的各种衡量标准，仅举几例。虽然所有这些变量都被证明与戒烟过程有关，但很难将这些变量组织成一个连贯的理论或描述人们如何戒烟。阶段模型可以帮助将结构和组织引入这些变量，从而为干预提供信息。如果吸烟者可以被安排在一组有序的类别中，导致戒烟，那么就可以为每一类吸烟者设计干预措施。换句话说，干预措施可以与阶段相匹配，因为不同阶段的吸烟者有不同的需求。 戒烟阶段模型的直观吸引力体现在过去20年来变化阶段模型的广泛使用上。变化结构的阶段是一个更大的模型的关键，该模型被称为跨理论模型(TTM)。然而，一些研究人员最近对TTM的基本原则表示了保留意见。Weinstein等人的研究成果。(1998)提出了评价阶段模型的四个原则：(1)阶段应该是定性不同的类别；(2)阶段应该是有序的序列；(3)每个阶段的人应该面临相似的变革障碍；(4)不同阶段的人应该面临不同的变革障碍。系统考察表明，TTM并不完全符合这些原则。这项拟议的研究旨在评估是否可以开发出与Weinstein等人的原则一致的戒烟阶段模型。 提出了三个定性的(即阶段性的)区分：1)想戒烟的人与不想戒烟的人的区别。2)打算戒烟的人与不打算戒烟的人区别开来。3)对如何戒烟有具体计划的人，与那些只有模糊戒烟意图的人有区别。问卷项目将被用来揭示戒烟是一个阶段性过程还是一个连续过程更好地描述。

DESCRIPTION (provided by applicant): Stage theories of health behavior have been increasingly popular over the past 20 years. Stage models are appealing because they bring structure and order to an otherwise complex and unwieldy skein of variables. To illustrate, consider the many variables that predict smoking cessation: smoking rates, past quit attempts, and various measures of nicotine dependence, to name a few. Whereas all these variables have been shown to be relevant to the process of smoking cessation, it is difficult to organize these variables into a coherent theory or description of how people quit smoking. A stage model could help bring structure and organization to these variables in a way that would inform interventions. If smokers could be arranged in an ordered set of categories leading to cessation, then interventions could be designed for each category of smoker. In other words, interventions could be matched to stage, because smokers in different stages would have different needs. The intuitive appeal of a stage model for smoking cessation is reflected by the widespread usage of the stages of change over past 20 years. The stages of change construct is the linchpin of a larger model know as the transtheoretical model (TTM). However, several researchers have recently expressed reservations regarding the basic tenets of the TTM. Weinstein et al. (1998) have proposed four principles for evaluating stage models: (1) stages should be qualitatively distinct categories, (2) stages should be an ordered sequence, (3) people within each stage should face similar barriers to change, and (4) people in different stages should face different barriers to change. A systematic review reveals that TTM does not accord well with these principles. The proposed research aims to evaluate whether a stage model for smoking cessation can be developed that would be consistent with the principles of Weinstein et al. Three qualitative (i.e., stage-like) distinctions are proposed: 1) Those who want to quit smoking as distinguished from those who to those who do not want to quit smoking. 2) Those who intend to quit smoking as distinguished from those who do not intend to quit smoking. 3) Those who have a specific plan of how to quit smoking as distinguished from those who have only a vague intention of quitting. Questionnaire items will be employed that are designed to reveal whether smoking cessation is better described as a stage process or a continuous process.