Kaufman Annette R, Koblitz Amber R, Persoskie Alexander, Ferrer Rebecca A, Klein William M P, Dwyer Laura A, Park Elyse R
Tobacco Control Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD;
Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD;
Nicotine Tob Res. 2016 Mar;18(3):321-9. doi: 10.1093/ntr/ntv091. Epub 2015 May 10.
Absolute and comparative risk perceptions, worry, perceived severity, perceived benefits, and self-efficacy are important theoretical determinants of tobacco use, but no measures have been validated to ensure the discriminant validity as well as test-retest reliability of these measures in the tobacco context. The purpose of the current study is to examine the reliability and factor structure of a measure assessing smoking-related health cognitions and emotions in a national sample of current and former heavy smokers in the National Lung Screening Trial.
A sub-study of the National Lung Screening Trial assessed current and former smokers' (age 55-74; N = 4379) self-reported health cognitions and emotions at trial enrollment and at 12-month follow-up. Items were derived from the Health Belief Model and Self-Regulation Model.
An exploratory factor analysis of baseline responses revealed a five-factor structure for former smokers (risk perceptions, worry, perceived severity, perceived benefits, and self-efficacy) and a six-factor structure for current smokers, such that absolute risk and comparative risk perceptions emerged as separate factors. A confirmatory factor analysis of 12-month follow-up responses revealed a good fit for the five latent constructs for former smokers and six latent constructs for current smokers. Longitudinal stability of these constructs was also demonstrated.
This is the first study to examine tobacco-related health cognition and emotional constructs over time in current and former heavy smokers undergoing lung screening. This study found that the theoretical constructs were stable across time and that the factor structure differed based on smoking status (current vs. former).
绝对风险感知、比较风险感知、担忧、感知严重性、感知益处和自我效能是烟草使用的重要理论决定因素，但尚未有经过验证的测量方法来确保这些测量方法在烟草背景下的区分效度和重测信度。本研究的目的是在国家肺癌筛查试验中，对一个评估当前和既往重度吸烟者吸烟相关健康认知和情绪的测量方法的信度和因子结构进行检验。
国家肺癌筛查试验的一项子研究评估了当前和既往吸烟者（年龄55 - 74岁；N = 4379）在试验入组时和12个月随访时自我报告的健康认知和情绪。条目源自健康信念模型和自我调节模型。
对基线反应的探索性因子分析显示，既往吸烟者为五因子结构（风险感知、担忧、感知严重性、感知益处和自我效能），当前吸烟者为六因子结构，绝对风险感知和比较风险感知成为独立因子。对12个月随访反应的验证性因子分析显示，既往吸烟者的五个潜在结构和当前吸烟者的六个潜在结构拟合良好。这些结构的纵向稳定性也得到了证实。
这是第一项在接受肺癌筛查的当前和既往重度吸烟者中，随时间检验与烟草相关的健康认知和情绪结构的研究。本研究发现，理论结构随时间稳定，且因子结构因吸烟状态（当前与既往）而异。
