Elsevier

Preventive Medicine

Volume 25, Issue 3, May 1996, Pages 277-285
Preventive Medicine

Regular Article
Heart, Body, and Soul: Impact of Church-Based Smoking Cessation Interventions on Readiness to Quit

https://doi.org/10.1006/pmed.1996.0057Get rights and content
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Abstract

Background.Given the relatively low spontaneous quit rates and poor treatment outcomes among African American smokers, this study was designed to evaluate the effects of a multimodal culturally relevant intervention for smoking behavior change compared with a self-help strategy among urban African Americans in Baltimore churches.

Method.This randomized controlled trial in urban African American churches used the stages of change model to compare the effectiveness of two interventions in moving smokers along a continuum toward smoking cessation. Twenty-two churches were randomly assigned to either an intensive culturally specific intervention or a minimal self-help intervention. Smokers were interviewed at baseline church health fairs and at a 1-year follow-up. Self-reported quitters at follow-up were evaluated using saliva cotinine and exhaled carbon monoxide levels (CO). Stages of change were measured by applying a standardized stages of change instrument to individual interview response sequences. Analysis compared the two intervention groups at 1-year follow-up with baseline stages. Outcomes included quit rates and positive progress along the stages of change.

Results.Multiple logistic regression results, controlling for intrachurch correlation and demographic and baseline smoking characteristics, showed that the multimodal cultural intervention group was more likely to make positive progress along the stages of change continuum, compared with the self-help intervention group (OR = 1.68;P= 0.04). Church denomination and intervention status interacted in the multivariate model; Baptists in the intensive intervention were three times (OR = 3.23;P= 0.010) more likely to make progress than all the other denomination groups.

Conclusion.The multimodal culturally relevant intervention was more likely than a self-help intervention to positively influence smoking behavior. This is the first community-based intervention study to report progress along the stages of change as a process-oriented measure of success. It is notable that a spiritually based model focusing on environmental sanctions was more likely than a standard church disseminated self-help intervention to positively influence smoking behavior in an urban African American population.

Keywords

smoking cessation
evaluation
stages of change
community-based intervention

Cited by (0)

This research was supported by Grant R01HL43604-6051 from the National Heart, Blood and Lung Institute, “Church-Based Smoking Cessation Strategies in an Urban Black Community.”

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To whom correspondence and reprint requests should be addressed at Johns Hopkins University/Sinai Hospital, Program in Internal Medicine, 2435 West Belvedere Ave., Hoffberger Suite 56, Baltimore, MD 21215-5271. Fax: (410)578-5638; E-mail [email protected].