The focus of this research is on the effects of message framing and contingency contracting on motivating and maintaining smoking cessation in patients with newly diagnosed cardiovascular disease. These two interventions have been selected because they are both innovative and cost effective. The sample will include medical and surgical patients who are newly diagnosed with either ischemic heart disease, myocardial infarction or peripheral vascular disease, recruited from inpatient settings, doctors' practices, and rehabilittion programs. In Phase One, the patients will be randomized into two groups, half receiving a gain from message advocating the benefits of quitting smoking and half receiving a loss frame message stating the losses accrued by continuing to smoke. They will be asked to participate in an eighteen month study of their smoking behavor. In Phase Two, patients will be randomized again into an information only control group (40%) and a contingency contracting group (60%). For those in the contingency contracting group the format of their contracts will also be randomized; half will receive gain frame contracts and half will receive loss frame contracts. The contracts will be negotiated with a behavioral counselor over the phone once a month for three months, bimonthly for six months and then for one three month period. A six month follow-up is also built into the study. In addition, all subjects will receive baseline questionnaires measuring their smoking self-efficacy and Health Locus of Control beliefs as well as their smoking status. Smoking status and smoking self-efficacy will be measured periodically through the eighteen months of study. It is predicted from Prospect Theory that loss frame messages will be a stronger motivator of smoking cessation than gain frame messages. Also, learning theory predicts that patients receiving contingency contracting will have a higher success rate than the controls. In addition, it is predicted that loss frame contracting will be more motivating than gain frame contracting. The analyses will also examine interactions between the individual difference variables and the interventions.
| Wilson, D K; Wallston, K A; King, J E et al. (1993) Validation of smoking abstinence in newly diagnosed cardiovascular patients. Addict Behav 18:421-9 |
