Computer expert systems for African-American smokers in physicians offices: a feasibility study

Area of Science:

• Public Health
• Behavioral Science
• Health Disparities

Background:

• Stage-based computer expert systems (CES) offer high participation and efficacy for public health impact.
• Targeting low-income African-American smokers with stress reduction tools may reduce smoking-related health disparities.

Purpose of the Study:

• To assess the feasibility, acceptability, and efficacy of a stage-tailored computer interactive feedback and stress reduction intervention.
• To evaluate participation and retention rates in a low-income African-American smoking population.
• To examine the fit of the transtheoretical model and 6-month shifts in stages of change.

Main Methods:

• Recruited 98 African-American smokers from a publicly funded clinic.
• Utilized computer interactive feedback and stress reduction audiotapes.
• Assessed participation, retention, acceptability, and stage of change at multiple time points.

Main Results:

• 55.6% participation and 75.5% retention rates observed.
• CES and audiotapes were rated as highly interesting, relevant, and new.
• Significant stage progression in smoking cessation was observed from baseline to 6 months (P < 0.0001).

Conclusions:

• Stage-tailored computer interactive feedback plus stress reduction is feasible and acceptable for low-income African-Americans.
• The intervention shows potential efficacy in promoting smoking cessation.
• Point-of-service delivery is a viable strategy for this population.