Papers by Catherine Segan
Family …, 2008
Inpractice management versus quitline referral for enhancing smoking cessation in general practic... more Inpractice management versus quitline referral for enhancing smoking cessation in general practice: a cluster randomized trial.Family Practice 2008; 25: 382-389. Background and objective. GPs are an important source of smoking cessation advice. This research examined whether a model encouraging GP referral of patients who smoke to a specialist service would be acceptable and effective for increased smoking cessation when compared with a model of in-practice management. Methods. The study design was cluster randomized controlled trial. Practices were randomized to one of two interventions, at a rate of 1:2: (i) standard in-practice GP management or (ii) referral to a quitline service. The main outcome measures were sustained abstinence of >1 month duration at 3-month follow-up and >10 months duration at 12 months, using intention to treat analysis.
Relapse prevention theory and practice has fo- cussed on teaching coping skills to deal with with... more Relapse prevention theory and practice has fo- cussed on teaching coping skills to deal with withdrawal and temptations to relapse with the result that treatments appear to be effective in reducing relapse over the short term, but not over the longer term. Once cravings subside ex- smokers face a further task of adjusting to a smoke-free lifestyle that involves learning
Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 2015
Secondhand smoke (SHS) is a significant cause of acute respiratory illness (ARI) and 5 times more... more Secondhand smoke (SHS) is a significant cause of acute respiratory illness (ARI) and 5 times more common in indigenous children. A single-blind randomized trial was undertaken to determine the efficacy of a family centered SHS intervention to reduce ARI in indigenous infants in Australia and New Zealand. Indigenous mothers/infants from homes with ≥1 smoker were randomized to a SHS intervention involving 3 home visits in the first 3 months of the infants' lives (plus usual care) or usual care. The primary outcome was number of ARI-related visits to a health provider in the first year of life. Secondary outcomes, assessed at 4 and 12 months of age, included ARI hospitalization rates and mothers' report of infants' SHS exposure (validated by urinary cotinine/creatinine ratios [CCRs]), smoking restrictions, and smoking cessation. Two hundred and ninety-three mother/infant dyads were randomized and followed up. Three quarters of mothers smoked during pregnancy and two thirds ...
Psychology & Health, 2002
This study tested the predictive value of the Transtheoretical Model (TTM) for the preparation to... more This study tested the predictive value of the Transtheoretical Model (TTM) for the preparation to action stage transition by conducting a detailed examination of changes in TTM components in the days leading up to, and following, a planned quit attempt. Participants were 193 callers to a Quitline telephone service. Only limited support for the TTM was found. Consistent with the
Preventive Medicine, 1998
Background. The Victorian "2 Fruit 'n' 5 Veg Every Day" campaign was aimed at increasing awarenes... more Background. The Victorian "2 Fruit 'n' 5 Veg Every Day" campaign was aimed at increasing awareness of A diet high in fruit and vegetables has been suggested the need to eat more fruit and vegetables and encouragas protective of a wide range of diseases, including caring increased consumption of these foods in the Austradiovascular disease, non-insulin-dependent diabetes lian state of Victoria. The demand-side component of mellitus, and certain forms of cancer . Current the campaign, which had television advertising as a recommendations by various health authorities suggest centerpiece, ran from 1992 to 1995.
Nicotine & Tobacco Research, 2013
introduction: Previous reviews have concluded that to be effective, evidence-based tobacco contro... more introduction: Previous reviews have concluded that to be effective, evidence-based tobacco control interventions should be culturally adapted to indigenous populations. We undertook a systematic review to critically examine this hitherto conclusion.
Health Psychology, 2004
C. A. Perz, C. C. DiClemente, and J. P. Carbonari (1996) claim support for the transtheoretical m... more C. A. Perz, C. C. DiClemente, and J. P. Carbonari (1996) claim support for the transtheoretical model notion that success in smoking cessation involves doing the right thing at the right time: emphasising experiential change processes during the contemplation and preparation stages and shifting to behavioral process activities during action. A key methodological limitation of Perz et al. was their failure to control for stage of change, a measure that has been shown to be predictive of cessation. This study replicates the prospective findings of Perz et al. in a different data set, then controls for stage of change when it is predictive of cessation, and finds that the measures of "appropriate" change process use developed by Perz et al. no longer predict cessation. The authors conclude that stage of change, in particular the distinction between smoking and not smoking, is more important than change process use in predicting cessation outcomes.
Health Education Research, 2007
Relapse prevention theory and practice has focussed on teaching coping skills to deal with withdr... more Relapse prevention theory and practice has focussed on teaching coping skills to deal with withdrawal and temptations to relapse with the result that treatments appear to be effective in reducing relapse over the short term, but not over the longer term. Once cravings subside exsmokers face a further task of adjusting to a smoke-free lifestyle that involves learning to think and act like a non-smoker. To highlight this task, we operationalized a new conceptual framework that describes three tasks of quitting (the 3Ts): (i) making a quit attempt; (ii) learning to effectively deal with cravings and withdrawal; and (iii) adapting to a smoke-free lifestyle. This was introduced to the Quitline service in Victoria, Australia, in preparation for a randomized controlled trial aimed at testing whether a program of four to six extra callbacks could help ex-smokers with the third task and as a result reduce rates of relapse compared with Quitline's standard callback program. This paper describes the conceptual framework (focussing on the third task) and initial reactions to it from both Quitline advisors and callers. The conceptual framework is now integrated in the service and appears to have changed the way Quitline operates and the apparent expectations of its clients.
Health Education Journal, 1999
Holidays in the sun have been identified as a risk factor for the development of melanoma. This p... more Holidays in the sun have been identified as a risk factor for the development of melanoma. This paper describes the development and evaluation of a brochure designed to reduce sun exposure in tourists travelling to high-risk destinations. The tourists came from an area where there are strong social norms for sun protection, so the focus of the brochure was to
BMC Public Health, 2010
Background: Depression is a common and distressing mental health problem that is responsible for ... more Background: Depression is a common and distressing mental health problem that is responsible for significant individual disability and cost to society. Medication and psychological therapies are effective for treating depression and maintenance anti-depressants (m-ADM) can prevent relapse. However, individuals with depression often express a wish for psychological help that can help them recover from depression in the long-term. We need to develop psychological therapies that prevent depressive relapse/recurrence. A recently developed treatment, Mindfulness-based Cognitive Therapy (MBCT, see http://www.mbct.co.uk) shows potential as a brief group programme for people with recurring depression. In two studies it has been shown to halve the rates of depression recurring compared to usual care. This trial asks the policy research question, is MBCT superior to m-ADM in terms of: a primary outcome of preventing depressive relapse/recurrence over 24 months; and, secondary outcomes of (a) depression free days, (b) residual depressive symptoms, (c) antidepressant (ADM) usage, (d) psychiatric and medical co-morbidity, (e) quality of life, and (f) cost effectiveness? An explanatory research question asks is an increase in mindfulness skills the key mechanism of change? Methods/Design: The design is a single blind, parallel RCT examining MBCT vs. m-ADM with an embedded process study. To answer the main policy research question the proposed trial compares MBCT plus ADM-tapering with m-ADM for patients with recurrent depression. Four hundred and twenty patients with recurrent major depressive disorder in full or partial remission will be recruited through primary care. Depressive relapse/recurrence over two years is the primary outcome variable. The explanatory question will be addressed in two mutually informative ways: quantitative measurement of potential mediating variables pre/post-treatment and a qualitative study of service users' views and experiences.
Australian Journal of Psychology, 2000
Addictive Behaviors, 2006
This study explored whether transtheoretical model (TTM) measures could predict relapse from the ... more This study explored whether transtheoretical model (TTM) measures could predict relapse from the action stage, i.e., during the first 6 months of smoking cessation. Predictors of relapse were examined between time 2 (3-month) and time 3 (6-month) assessments (n = 247), and also between time 3 (6-month) and time 4 (12-month) assessments (n = 204). Consistent predictors of relapse included lower self-efficacy and determination to quit and higher temptations to smoke. Some predictors of relapse changed according to how long a person had already been quit for. Contrary to the TTM, greater behavioral change process use predicted relapse among people who had already quit for less than a month, and did not prevent relapse among those who had already quit for a month or more between time 2 and time 3. Cross-sectional analyses showed significant decreases in temptations to smoke and in the use of some of the change processes, which stabilised at about 1 month post-cessation. The findings suggest that there may be a stage boundary at around 1 month post-cessation, and question the homogeneity, and hence validity, of the TTM-defined action stage of change.
Addiction, 2003
Aim To assess the effectiveness of a program of computer-generated tailored advice for callers to... more Aim To assess the effectiveness of a program of computer-generated tailored advice for callers to a telephone helpline, and to assess whether it enhanced a series of callback telephone counselling sessions in aiding smoking cessation. Design Randomized controlled trial comparing: (1) untailored self-help materials; (2) computer-generated tailored advice only, and (3) computer-generated tailored advice plus callback telephone counselling. Assessment surveys were conducted at baseline, 3, 6 and 12 months. Setting Victoria, Australia. Participants A total of 1578 smokers who called the Quitline service and agreed to participate. Measurements Smoking status at follow-up; duration of cessation, if quit; use of nicotine replacement therapy; and extent of participation in the callback service. Findings At the 3-month follow-up, significantly more ( c 2 (2) = 16.9; P < 0.001) participants in the computer-generated tailored advice plus telephone counselling condition were not smoking (21%) than in either the computer-generated advice only (12%) or the control condition (12%). Proportions reporting not smoking at the 12-month follow-up were 26%, 23% and 22%, respectively (NS) for point prevalence, and for 9 months sustained abstinence; 8.2, 6.0, and 5.0 (NS). In the telephone counselling group, those receiving callbacks were more likely than those who did not to have sustained abstinence at 12 months (10.2 compared with 4.0, P < 0.05). Logistic regression on 3-month data showed significant independent effects on cessation of telephone counselling and use of NRT, but not of computer-generated tailored advice. Conclusion Computer-generated tailored advice did not enhance telephone counselling, nor have any independent effect on cessation. This may be due to poor timing of the computer-generated tailored advice and poor integration of the two modes of advice.
Addiction, 2001
The development of acceptable, widely available and effective smoking cessation methods is centra... more The development of acceptable, widely available and effective smoking cessation methods is central to public health strategy for tobacco control. We examined the effectiveness of a telephone callback counselling intervention, compared to the provision of self-help resources alone. Participants were 998 smokers calling a state-wide &quot;Quitline&quot; service randomly allocated to either callback counselling or ordinary care. The callback condition consisted of a series of brief counselling calls at strategic times in addition to ordinary care. The number of calls varied according to caller needs, and most occurred generally just before the person&#39;s quit day and in the week or two after it. The service was delivered by trained telephone counsellors. At the 3-month follow-up, significantly more participants in the callback group (24%) reported that they were quit, compared to those in the usual care comparison group (13%). The difference in point prevalence of smoking declined to 6% by the 12-month follow-up. Using sustained abstinence there was a significant benefit of callback counselling at 12-month follow-up. Treating dropouts as smokers reduced the overall magnitude of the effects somewhat. The benefit of callbacks was to marginally increase quit attempts and to significantly reduce relapse. Our findings are consistent with those of other studies demonstrating benefits of callback telephone counselling to facilitate cessation. Such counselling provides a flexible, relatively inexpensive and widely available form of cessation service. It appears to encourage a greater proportion of quit attempts and to reduce the rate of relapse among those quitting. Further research is required to determine ways to enhance effectiveness, particularly studies of how to reduce relapse.
Family Practice, 2008
Inpractice management versus quitline referral for enhancing smoking cessation in general practic... more Inpractice management versus quitline referral for enhancing smoking cessation in general practice: a cluster randomized trial.Family Practice 2008; 25: 382-389. Background and objective. GPs are an important source of smoking cessation advice. This research examined whether a model encouraging GP referral of patients who smoke to a specialist service would be acceptable and effective for increased smoking cessation when compared with a model of in-practice management. Methods. The study design was cluster randomized controlled trial. Practices were randomized to one of two interventions, at a rate of 1:2: (i) standard in-practice GP management or (ii) referral to a quitline service. The main outcome measures were sustained abstinence of >1 month duration at 3-month follow-up and >10 months duration at 12 months, using intention to treat analysis.
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Papers by Catherine Segan