The purpose of this application for a 5-year Mentored Patient-Oriented Research Career Development Award (K23) on smoking among incarcerated females is to conduct research and training activities to advance the candidate's development as an independent clinical researcher. This includes formal classwork pertaining to research design, biostatistics, and ethics along with conference attendance and meetings with mentors. The proposed research plan includes two studies that build upon each other in the area of smoking among female prisoners. The first study is cross-sectional and is designed to investigate the smoking behavior of incarcerated females. In addition, this study will examine differences between smokers, ex-smokers, and non-smokers on measures of substance abuse and personality, with consideration to other key covariables such as criminal history, medical problems, readiness to change, and Axis I pathology as possibly differentiating between the three groups. The second study will be a clinical trial using Hall et al.'s (1994) Mood Management group smoking cessation intervention combined with nicotine patch (or no patch). The intervention group will be compared to a wait-list control group who will receive the treatment six months later. It is expected that women who successfully complete the intervention will have higher smoking cessation rates than wait-list controls. Further, it is hypothesized that women with substance abuse and psychiatric comorbidity will have poorer outcomes than those without comorbidity. These projects should add significant information to the literature which is currently devoid of research related to smoking and female prisoners. This is particularly relevant now as it has been shown that women may have more difficulty with quitting smoking than men and may also have additional concerns related to smoking (e.g., smoking as weight management) that influence their success. Testing effective smoking cessation interventions with this underserved and understudied population is urgently needed as the medical costs associated with treating prisoners currently accounts for 11% of the Department of Corrections' budget and is expected to double over the next 10 years. Overall, these projects will provide experiences necessary for the candidate to develop an independent research program focusing on effective smoking interventions for incarcerated individuals.
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