A clinical trial will test (1) an intervention derived from self- determination theory and applied to smoking cessation, diet improvement, or both, as compared to usual care and (2) the self-determination model of the processes that underlie maintained health-behavior change. All participants will be adult cigarette smokers, stratified in terms of whether their LDL cholesterol is or is not at NCEP-recommended goal (which varies as a function of health and risk status). Those at goal will be randomly assigned either to a self-determination intervention or to usual care for smoking cessation. Those not at goal will be randomly assigned to one of four conditions created by the factorial cross of a self-determination intervention versus usual cre for reduction in dietary fat intake. Thus, we will test the effects of the self- determination-theory intervention for smoking cessation, diet improvement, and both. Further, using Structural Equation Modeling we will test the fit of the self-determination model to the data both within the intervention groups and within the usual-care groups. The 6-month intervention for smoking cessation and diet improvement involves a behavior-change counselor working with participants to encourage and support change of one or both of these two risk behaviors (depending on experimental condition). The counselor will employ self- determination theory principles, which include eliciting and acknowledging the patients' perspectives and values, providing choices and relevant information, promoting perceived competence, and minimizing pressure to change. The intervention, which is consistent with and builds upon the AHCPR guidelines for smoking cessation and the NCEP guidelines for lowering cholesterol was designed to operationalize the positions of self-determination theory so its applicability to change of these two health-risk behaviors could be tested. Outcomes assessed at 6 and 18 months include 7-day point prevalence smoking cessation (validated by serum cotinine), reduction in percentage of calories from rat assessed by 24 dietary recalls, and improvement in measured and calculated LDL cholesterol.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
1R01MH059594-01
Application #
2805335
Study Section
Special Emphasis Panel (ZRG1-HUD-2 (01))
Program Officer
Muehrer, Peter R
Project Start
1999-07-01
Project End
2003-06-30
Budget Start
1999-07-01
Budget End
2000-06-30
Support Year
1
Fiscal Year
1999
Total Cost
Indirect Cost
Name
University of Rochester
Department
Other Clinical Sciences
Type
Schools of Arts and Sciences
DUNS #
208469486
City
Rochester
State
NY
Country
United States
Zip Code
14627
Williams, Geoffrey C; Niemiec, Christopher P; Patrick, Heather et al. (2016) Outcomes of the Smoker's Health Project: a pragmatic comparative effectiveness trial of tobacco-dependence interventions based on self-determination theory. Health Educ Res 31:749-759
Pesis-Katz, Irena; Williams, Geoffrey C; Niemiec, Christopher P et al. (2011) Cost-effectiveness of intensive tobacco dependence intervention based on self-determination theory. Am J Manag Care 17:e393-8
Williams, Geoffrey C; Patrick, Heather; Niemiec, Christopher P et al. (2011) The smoker's health project: a self-determination theory intervention to facilitate maintenance of tobacco abstinence. Contemp Clin Trials 32:535-43
Williams, Geoffrey C; Niemiec, Christopher P; Patrick, Heather et al. (2009) The importance of supporting autonomy and perceived competence in facilitating long-term tobacco abstinence. Ann Behav Med 37:315-24
Niemiec, Christopher P; Ryan, Richard M; Deci, Edward L et al. (2009) Aspiring to physical health: the role of aspirations for physical health in facilitating long-term tobacco abstinence. Patient Educ Couns 74:250-7
Hebert, James R; Hurley, Thomas G; Peterson, Karen E et al. (2008) Social desirability trait influences on self-reported dietary measures among diverse participants in a multicenter multiple risk factor trial. J Nutr 138:226S-234S
Peterson, Karen E; Hebert, James R; Hurley, Thomas G et al. (2008) Accuracy and precision of two short screeners to assess change in fruit and vegetable consumption among diverse populations participating in health promotion intervention trials. J Nutr 138:218S-225S
Williams, Geoffrey C; Hurley, Thomas G; Thompson, Frances E et al. (2008) Performance of a short percentage energy from fat tool in measuring change in dietary intervention studies. J Nutr 138:212S-217S
Davis, Rachel E; Resnicow, Ken; Atienza, Audie A et al. (2008) Use of signal detection methodology to identify subgroups of dietary supplement use in diverse populations. J Nutr 138:205S-211S
Beresford, Shirley A A; Klesges, Lisa M; Rockett, Helaine R H (2008) The examination of two short dietary assessment methods, within the context of multiple behavioral change interventions in adult populations. Introduction. J Nutr 138:183S-184S

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