Adapting a Functional Assessment of Cigarette Smoking for People with Intellectual and Developmental Disabilities

There is a concerning lack of published smoking cessation research on people with intellectual and developmental disabilities (IDD). A Functional Assessment for Smoking Treatment Recommendations (FASTR) was recently developed to help personalize patients' tobacco treatment. Adapting this tool to effectively identify putative environmental variables that maintain smoking for people with IDD is predicted to improve current treatments. The purpose of this study was to pilot the FASTR with people with IDD to understand modifications necessary to implement it in this population. During 1-hour interviews participants (n = 8) described the extent they agreed with each FASTR statement using a Likert scale, corresponding to one of five potential functions of smoking (i.e., Automatic Positive, Automatic Negative, Social Positive, Social Negative, and Antecedent). Participants gave input on potential modifications to make the assessment more inclusive for people with IDD. A quantitative approach was used to pilot the FASTR and participant narratives were used to understand difficulties and potential modifications. For each participant a function was endorsed if the average response to questions corresponding to that function was greater than 3 (neutral) or over 50% "yes" responses. The two most frequently endorsed functions were Automatic Negative (87.5% participants) and Social Negative (75% of participants). Participants recommended making the focus of each statement larger and in bold so respondents can understand the most important part of the statement. The FASTR was modified based on their feedback and will be distributed to a larger sample of people with IDD for further validation.