||5R01CA137616-06 Interpret this number
||Motivating Smokers with Mobility Impairments to Quit Smoking
People with physical disabilities experience similar health disparities as other disadvantaged groups (e.g.,
no insurance, decreased access to medical and preventive care, more co-morbidities) but significantly less
attention is paid to their health promotion. While smoking cessation interventions have been developed for
other disadvantaged groups, none exist for people with physical disabilities. People with physical disabilities
(mobility impairments) who use assistance to ambulate have higher smoking rates (32.5%) than people who
have a disability and do not need assistance (23%) and people who are not disabled (19.8%; Brawarsky et al.
2002). The aims of the current study are to: 1) develop a series of theory-based intervention DVDs focused on
motivating smoking cessation among people with mobility impairments (i.e., chronically use some type of
assistance to walk such as walker, cane, wheelchair, braces, etc) and 2) test the efficacy of the Intervention
DVDs vs. Print-based Standard Care among 560 smokers with mobility impairments in a randomized trial. The
materials in both groups will be mailed on a monthly basis for four months, and are organized in separate
sections according to readiness to quit. Participants in both groups will receive a) nicotine patches at no cost if
they are ready to quit and b) brief phone calls (~5 minutes) between mailings to assess and encourage viewing
the materials. We hypothesize that smokers who are randomized to receive the Intervention DVDs will be
significantly more likely to achieve 7-day and 30-day point-prevalence abstinence at 1, 6, and 12- month
follow-ups vs. those who receive Print-based Standard Care. The Intervention DVDs will be based on
Behavioral Activation Theory, and address specific barriers to quitting in this population (increased stress,
decreased positive affect, increased depressed mood, activity restriction, and self-efficacy). We hypothesize
that the intervention will impact these mediators directly, as well as indirectly through Behavioral Activation
(goal setting and pleasant events). Our series of preliminary studies support the use of these mediators for
people with mobility impairments and the use of DVDs as an acceptable mode of intervention, given the
economic and mobility limitations of this population. If effective, our DVD intervention could have a high level
of public health and clinical significance, as it could be easily disseminated at low cost through national
disability-related organizations, networks of independent living centers, or physician offices, and substantially
improve the health and quality of life for people with physical disabilities. This study is innovative because no
studies have targeted this population, it applies Behavioral Activation Theory to smoking cessation, and it
examines relatively novel mediators in the field of smoking (e.g., positive affect, behavioral activation).
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