Cancer Prevention Research Center, Department of Psychology, College of Health Sciences, University of Rhode Island, Kingston, RI, USA.
Department of Medicine, Cook County Health and Hospital System and Rush University, Chicago, IL, USA.
Transl Behav Med. 2020 May 20;10(2):457-468. doi: 10.1093/tbm/ibz001.
People with and at risk for HIV have high rates of smoking, increasing their morbidity and mortality. Effective cessation interventions are needed for this group. Transtheoretical model (TTM)-tailored interventions have demonstrated efficacy, but measures need cross-validation in this population. TTM cessation measures were evaluated in women smokers with and at risk for HIV (N = 111) from Chicago Women's Interagency HIV Study (WIHS). Confirmatory factor analyses evaluated measurement models. MANOVAs examined relationships between constructs and stage subgroups. For decisional balance, the two-factor uncorrelated model was best (χ2(20) = 13.96; comparative fit index [CFI], 1.0; root mean square error of approximation [RMSEA] = .00), with good (pros α = .78) and fair (cons α = .55) four-item alphas. The one-factor temptations model (α = .90) showed reasonable fit (χ2(18) = 80.22; CFI = .89; RMSEA = .177). Processes of change subscales had fair to good two-item alphas (α = .49-.77) and fit a 10-factor fully correlated model (χ2(125) = 222.72; CFI = .88; RMSEA = .084). MANOVAs by stage of change replicated expected patterns for the pros, overall temptations, and two process subscales with medium-sized effects (η2 = .06-.18). Contrary to expectations, no differences by stage were found for cons or temptation negative affect subscales. The structures of these TTM measures replicated with good internal and external validity, except for the cons, which needs refinement. Negative affect temptations was structurally sound, but did not vary by stage group potentially reflecting this sample's moderate depression levels and/or their reliance on smoking to deal with negative affect. Results support the use of most TTM measures in research and tailored interventions to increase smoking cessation among women smokers with and at risk for HIV and highlight the importance of managing negative affect in cessation materials targeting this group.
患有艾滋病病毒和有感染艾滋病病毒风险的人吸烟率很高，这增加了他们的发病率和死亡率。该群体需要有效的戒烟干预措施。经证明，跨理论模型（TTM）量身定制的干预措施是有效的，但这些措施需要在这一人群中进行交叉验证。TTM 戒烟措施在来自芝加哥妇女机构间艾滋病毒研究（WIHS）的 111 名患有艾滋病病毒和有感染艾滋病病毒风险的女性吸烟者中进行了评估。验证性因素分析评估了测量模型。MANOVA 检验了结构与阶段亚组之间的关系。对于决策平衡，两因素不相关模型最佳（χ2(20)=13.96；比较拟合指数 [CFI]，1.0；近似均方根误差 [RMSEA] = 0.00），具有良好（pros α = 0.78）和公平（cons α = 0.55）的四项条目信度。单一因素诱惑模型（α=0.90）显示出合理的拟合度（χ2(18)=80.22；CFI=0.89；RMSEA=0.177）。变化过程分量表具有公平到良好的两项目标信度（α=0.49-0.77），并符合 10 因素完全相关模型（χ2(125)=222.72；CFI=0.88；RMSEA=0.084）。按变化阶段进行的 MANOVA 复制了预期的 pros、总体诱惑和两个过程分量表的模式，具有中等大小的效果（η2=0.06-0.18）。与预期相反，在 cons 或诱惑负性情绪分量表上，没有发现与阶段相关的差异。除了 cons 需要改进之外，这些 TTM 措施的结构具有良好的内部和外部有效性。诱惑负性情绪的结构合理，但没有因阶段组而异，这可能反映了该样本的中度抑郁水平和/或他们依赖吸烟来应对负性情绪。研究结果支持在研究和量身定制的干预措施中使用大多数 TTM 措施，以增加患有艾滋病病毒和有感染艾滋病病毒风险的女性吸烟者的戒烟率，并强调在针对该人群的戒烟材料中管理负性情绪的重要性。
