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A web-based support community as a tool for ST cessation

Institution: University of California, San Francisco
Investigator(s): Margaret Walsh, MS, EdD
Award Cycle: 2003 (Cycle 12) Grant #: 12IT-0169 Award: $100,000
Subject Area: Tobacco-Use Prevention and Cessation
Award Type: Inno Dev & Exp Awards (IDEAS)
Abstracts

Initial Award Abstract
College athletes are heavy users of spit (smokeless) tobacco (ST). Despite awareness of adverse health effects of regular ST use, relatively few studies have focused on ST cessation and there is no consistent cessation program in place to assist ST-using college athletes To begin to address this problem, we worked with informatics and computer technology experts at A-frame Inc, a community-based computer software company, to build a professionally monitored web-based support community (PMWSC) to help ST users who wish to quit or reduce their tobacco use. Building on our previous work, this proposed study is an IDEA project – a small study testing the feasibility of a novel approach. The objectives of this pilot study are: 1) to continue to partner with A-frame Inc to create a professionally monitored web-based support community (PMWSC) for ST users that includes a virtual world chat room to provide “real time” interaction with a trained cessation facilitator and other ST users and a professionally moderated discussion forum to allow a professionally monitored discussion forum in “asynchronous time”; 2) to test it for usability with 10 ST-using athletes; 3) to pilot test PMWSC for usability and acceptability among 30 ST-using baseball athletes; and, 4) to conduct a pilot study among 60 ST-using college baseball athletes to evaluate the effect on short-term ST behavior and attitudes toward quitting of the PMWSC condition compared to a pretest and posttest only condition.

Six college baseball teams will be matched for prevalence of ST use and randomly assigned to either the PMWSC group or to a paper and pencil pretest/posttest-only group. Using either college library computers or personal computers, ST users in the PMWSC group will interact over a 4-week period in five 1-hour chat sessions (2 sessions in week 1 and then 1 per week in weeks 2, 3 and 4 on a professionally monitored discussion forum for asynchronous communication). ST behavior (i.e., self-reported ST use, amount used, and number of quit attempts) and attitudes toward quitting (i.e., perception of pros and cons of quitting, readiness to quit, confidence about being able to quit, and intentions to quit) will be assessed at the beginning of the study and at 1-month follow-up in the PMWSC group, and at the beginning of the study and one month later for the pre-test/post-test only group. ST behavior and associated attitudes will be compared between groups at baseline and at the 1-month follow-up using odds ratios and confidence intervals. For the PMWSC, changes over the 3 time periods as well as usability and acceptability will be analyzed. The proposed novel program has the potential to reach a large number of high risk athletes in many sports, using the internet to cut across geographical barriers and distances and may prove to be a valuable adjunct to a comprehensive approach to reduce use of ST among student athletes.