Date on Master's Thesis/Doctoral Dissertation

12-2016

Document Type

Doctoral Dissertation

Degree Name

Ph. D.

Department

Nursing

Degree Program

Nursing, PhD

Committee Chair

Ridner, S. Lee

Committee Co-Chair (if applicable)

Hall, Lynne

Committee Member

Hall, Lynne

Committee Member

Staten, Ruth

Committee Member

Walker, Kandi

Author's Keywords

smoking; college; motivational interviewing; text message; behavior regulation

Abstract

Purpose: The purpose of this dissertation was to examine the effects of a novel text message-based motivational interviewing intervention on cigarette smoking behavior in college students. Three manuscripts comprised this dissertation and included: a state of the science review of motivational interviewing and text message-based smoking behavior interventions in adolescents and young adults; a critical review and analysis of instruments used to measure nicotine dependence in young adults; and a quasi-experimental study testing the effects of a novel text message-based motivational interviewing intervention on cigarette smoking behavior in college students. Background: Cigarette smoking is the number one preventable cause of chronic disease and death in the United States. Despite available information and preventive efforts, approximately 10% of college students smoke cigarettes. Although many studies have confirmed this public health concern, few attempted modification of smoking behavior in college students. A critical review of the literature revealed that the vast majority of smoking behavior research in college students was epidemiological in nature, and few interventions were designed specifically for college students who smoke. Main findings from this review suggested that motivational interviewing and text messaging interventions were successfully used among adolescents and young adults and hold strong potential for college students. However, more investigations, especially studies examining joint interventions of motivational interviewing and text-messaging, are needed. The second manuscript reviewed commonly used self-report nicotine dependence measures used with young adult populations. Three instruments, including the Fagerstrӧm Test for Nicotine Dependence, the Cigarette Dependence Scale, and the Hooked on Nicotine Checklist, were identified as the most commonly used instruments and were subjected to further psychometric analysis. Methods: The third manuscript summarized a quasi-experimental study designed to test the effects of a novel text message-based motivational interviewing intervention (iMI) on cigarette smoking behavior in college students and to provide a better understanding of smoking behavior regulation. The aims of the study were to : (1) test the effects of the iMI on cognitive parameters of behavior regulation (psychological needs satisfaction, autonomous motivation, smoking self-efficacy, and readiness to quit) among college students who smoke, (2) evaluate the effect of the intervention on smoking behavior (number of cigarettes smoked per day and severity of nicotine addiction) between baseline and 2-week post-intervention follow-up, and (3) identify independent predictors of change in smoking behavior among college students, from baseline to 2-week post-intervention follow-up. Undergraduate students (N = 33) were recruited to participate in the study that lasted five weeks (3-week intervention program with 2-week post-intervention follow-up assessment). Data were analyzed to determine differences in behavior regulation and smoking behavior parameters from baseline to 2-week post-intervention follow-up and identify independent predictors of change in smoking behavior among study participants. Results: The findings indicated that intervention was successful in affecting positive changes in smoking behavior regulation (autonomy and relatedness needs satisfaction, autonomous motivation, and smoking cessation self-efficacy) and reducing smoking behavior (cigarettes smoked per day). Smoking cessation self-efficacy was the strongest behavior regulation predictor of smoking behavior in college students. Conclusions: The findings of this dissertation support current evidence of motivational interviewing efficacy in smoking behavior modification and contribute to a deeper understanding of the underlying predictors of smoking in college students. Since this is the first study to examine the effects of a text-based motivational interviewing intervention on college student smoking, replication studies are warranted.

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