Self-help materials computer-tailored to the specific needs of smokers have shown promise as a high-reach, low-cost intervention for smoking cessation. Adding tailored cessation materials to telephone-based cessation counseling may be a way of generating greater efficacy in promoting and maintaining cessation. The objective of this study is to assess the efficacy of adding different types of behavioral smoking cessation materials to brief telephone-based cessation counseling.A total of 1,978 smokers calling the National Cancer Institute's (NCI's) Cancer Information Service (CIS) for help in quitting smoking initially received brief cognitive-behavioral cessation counseling from a CIS information specialist. Following a baseline interview administered by the information specialist, subjects were randomly assigned to one of four conditions, each delivered by U.S. mail: a single, untailored smoking cessation guide (SU); a single, tailored smoking cessation guide (ST); a series of four (multiple) printed materials tailored only to baseline data (MT); and a series of four (multiple) printed materials tailored to baseline as well as retailored using 5-month interim progress data (MRT). The primary outcome measure was 7-day point prevalence abstinence rates assessed using a computer-assisted telephone interview (CATI) at 12-month follow-up.At 12-month follow-up, using intent-to-treat, imputed, and per-protocol analyses, no differences were found among the four experimental conditions (linear trend), or when the ST, MT, and MRT groups were compared with the control (SU) group. Participants in the two multiple message group conditions combined (MT + MRT), however, had significantly higher abstinence rates than participants in the two single message group conditions combined (SU + ST). Moreover, among subjects who reported quitting at the 5-month follow-up, participants receiving the MRT materials reported higher abstinence rates at 12 months than the other three groups combined (SU + ST + MT). The results of this study support the effectiveness, over and above a single telecounseling interaction, of multiple tailored print material contacts on cessation. These effects, however may be due to tailoring, or the longitudinal nature of the two multiple tailored conditions, or both. The strongest evidence for tailoring occurred in the MRT condition for relapse prevention, suggesting that print materials tailored to interim progress may be especially effective in this context. The qualities of specific psychosocial and communication elements in tailored materials should receive attention in future research.

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Objectives:To examine the comfort level and survey preferences of participants who completed handheld computer-assisted self-interviews (H-CASI). Methods: Obstetrics patients (N=187) were surveyed about their comfort with the H-CASI and its readability, likeability, ease of use, and preferability over paper-and-pencil surveys. Results: Most participants were comfortable using the handheld computer and stated a preference of H-CASI over paperand-pencil surveys. Previous computer experience and lower education level predicted greater handheld-computer preference. Conclusion: Results suggest that data collection using H-CASI may be an appropriate and preferable strategy for many participants.

Although health care providers appear to be an obvious choice for delivering smoking cessation education, they often lack the resources, training, and time to provide anything more than a recommendation to quit and generic pamphlets for reinforcement. Traditionally, this type of material is designed to include information for many potential users, thus making it diYcult for an individual to find the pieces most relevant to them. In contrast, tailored print materials provide only information which is relevant to a subject, making it far more usable. One study assessing tailored print messages found a threefold increase in cessation rates among patients in a family practice setting, four months after receipt of tailored versus untailored smoking cessation messages.1 Numerous other studies, targeting a number of diVerent populations, have also shown that tailored messages are an eVective intervention for smoking cessation. In tailoring, we use individual patient responses to select only relevant behaviour change messages. These messages provide information specific to an individual's needs and interests and can reinforce messages from health professionals. Because they are personalised, tailored materials oVer a potentially superior alternative to generic materials designed to reach a broad audience. Quit for Keeps used a pre-test/post-test experimental design to test the eVects of tailored interventions on pregnant smokers. MethodsParticipants in this study included 92 women enrolled at the Taubman obstetrics and gynaecology (ob/gyn) clinic at the University of Michigan and 81 women enrolled at the ob/gyn clinic at the University of North Carolina hospital from December 1996 to December 1997. Eligible participants were those who reported having smoked at least 100 cigarettes in their lifetime and who were either still smoking or had quit since becoming pregnant. Subjects were screened for eligibility during the New to the Nurse orientation program in North Carolina or during their first pre-natal visit to the clinic in Michigan. Potential subjects were given a hand held computer (Apple Newton MessagePad) and asked to fill out a short screening survey. After the computer determined that a subject was eligible, she was then approached by a research assistant and asked to participate in the project. Consenting women were then given the hand held computer for a second time and asked to complete the baseline questionnaire which assessed smoking status and asked questions on behavioural and psychosocial variables, including: stages of change for quitting smoking, perceived benefits of and barriers to quitting, self eYcacy, and demographic information. These constructs were used to create the tailored messages for those subjects randomised to the experimental condition. A urine sample was collected at baseline to confirm smoking status, and values < 80 ng/ml were considered indicative of abstinence.Subjects were then randomised via computer algorithm and assigned to either the control or experimental condition. Subjects ...

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