Publication Date

2013-12-04

Availability

Open access

Embargo Period

2013-12-04

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PHD)

Department

Architecture (Architecture)

Date of Defense

2013-11-01

First Committee Member

Monica Webb Hooper

Second Committee Member

Neil Schneiderman

Third Committee Member

Frank J. Penedo

Fourth Committee Member

Amy G. Weisman de Mamani

Fifth Committee Member

Noella A. Dietz

Abstract

Culturally specific smoking cessation interventions have been recommended for racial/ethnic minority smokers in the U.S., though few cessation trials have focused on Hispanics. As a result, little is known about effective intervention delivery or factors that should be considered. The aims of this study were to test the acceptability and efficacy of a smoking cessation intervention varying in cultural specificity and language. Participants (N = 222) were English-Spanish bilingual Hispanic smokers recruited from the community. A 2 (Language: preferred vs. less preferred) X 2 (Intervention type: standard vs. culturally specific) between-subjects experiment was conducted. Language preference was assessed, and participants were randomly assigned to one of four conditions: (1) culturally specific smoking cessation intervention, preferred language; (2) standard intervention, preferred language; (3) culturally specific intervention, less preferred language; or (4) standard intervention, less preferred language. The dependent variables measured intervention acceptability (intervention satisfaction, utilization, and content evaluation) and efficacy (readiness to quit, pros and cons of smoking, and smoking related knowledge). Hypotheses included: (1) a main effect of language, such that preferred language would result in greater acceptability and efficacy compared to less preferred language; (2) a main effect of intervention type, such that the culturally specific intervention would result in greater acceptability and efficacy compared to the standard intervention; and (3) an interaction effect, such that the culturally specific intervention in participants’ preferred language would result in greater acceptability and efficacy than the standard intervention in participants’ less preferred language. Acculturation was controlled for in all main analyses. Contrary to expectations, results indicated that the standard intervention led to greater satisfaction compared to the culturally specific intervention. However, as hypothesized, a main effect of language demonstrated greater intervention utilization in the preferred language conditions compared to the less preferred language conditions. A main effect of intervention type demonstrated greater cons of smoking in the culturally specific conditions compared to the standard conditions. A main effect of intervention type demonstrated a greater reduction in cigarettes per day at the two-week follow up in the culturally specific conditions compared to the standard conditions. Exploratory analyses were conducted to examine intervention effects in subgroups of the sample, by household income, generational status, and gender. These analyses revealed that content evaluation scores were highest for participants who earned more than $20,000 per year and received the intervention in their preferred language. Second, participants who earned more than $20,000 per year reported greater readiness to quit than those who earned less. Third, there was a main effect of generational status on the pros of smoking: first generation immigrants had lower pros of smoking scores after the intervention compared to those who were U.S.-born. Fourth, there was a main effect of gender on knowledge: women had higher smoking-related knowledge scores after the intervention than men. Finally, self-reported cessation was greater in the preferred language conditions compared to the less-preferred language conditions. In conclusion, this is the first study to compare a culturally specific smoking cessation intervention to a standard intervention for Hispanic smokers, with treatment intensity matching. This study is an important step in demonstrating that cultural specificity can lead to changes in the appraisals of smoking and in behavior change, and it contributes to the literature in the development of interventions targeting this growing subgroup.

Keywords

smoking cessation; Hispanic/Latino; culturally specific interventions

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