Colleen A. Redding - US grants

[unreadable] DESCRIPTION (provided by applicant): Smoking remains one of the biggest causes of premature morbidity and mortality. Nicotine addiction continues to challenge researchers to optimize their best interventions, and these challenges increase with efforts to integrate smoking cessation into multiple behavior change research and dissemination. Tailored intervention strategies have demonstrated effectiveness, yet much research remains to be done exploring optimal tailoring strategies. Transtheoretical model (TTM) tailored feedback on all 14 variables has been demonstrated to be a robust population cessation strategy across studies, producing 22-25% quit rates at 18-24 month final timepoints. This proposal seeks to find a subset of these variables that is optimal for tailoring, both minimizing response burden while maximizing effectiveness. Addiction variables have been demonstrated to predict smoking outcomes across studies as well, so we will integrate tailored feedback using TTM and addiction variables into an enhanced tailoring group. Enhanced addiction tailored feedback that both helps unmotivated smokers reduce their addiction and helps motivated smokers quit could lead to a breakthrough in population cessation. This proposal tests four types of TTM-tailoring for smoking cessation in an additive design: no treatment control group; Minimal tailoring (stage only); Moderate tailoring (stage, pros, cons, efficacy); Full TTM tailoring (all 14 TTM variables); and Enhanced TTM tailoring plus addiction variables. Smokers will be randomized to one of five treatment groups and evaluated at baseline, 6 months, 12 months, and 24 months. Treatment groups will receive tailored feedback at baseline, 6 months, and 12 months. Analyses will compare treatment groups on quit rates at the final timepoint to see how effectively each treatment helps smokers to quit. A series of mediation and moderation analyses will examine how each treatment works. This study has the potential to find an optimal tailoring strategy for population cessation that could accelerate future multiple behavior change research and dissemination efforts. [unreadable] [unreadable] [unreadable]

DESCRIPTION (provided by applicant): The aims and themes of this proposal reflect mechanisms of single and multiple behavior change with an emphasis on cancer risk behaviors to add to our understanding of effective behavior change interventions that can promote behavior change and public health while reducing healthcare costs. The efficacy of tailored programs currently available is still not strong enough, and one of the most important barriers to enhancing the efficiency and effectiveness of behavior interventions is insufficient knowledge about the mechanisms of behavior change. Such mechanisms have been viewed, essentially, as a black box with unknown contents. Conducting empirical research using a variety of new methods to target this 'black box' and elucidate its contents is critical for progressing to the net generation of intervention systems. The proposed study will employ latent class analysis (LCA) and latent transition analysis (LTA) to model the complex mechanisms of single and multiple behavior change in four cancer risk behaviors, including smoking, unhealthy diet, sun exposure, and inactivity. Secondary data analyses will integrate data from four population-based intervention trials targeting (a) two different samples of parents of adolescents (N's = 2,460, and 2,547), (b) one sample from patients from an insurance provider list (N = 5,382), and (c) worksite employees (N = 1,906). All four randomized trials targeted smoking, diet and sun exposure, and one trial of parents and one of employees targeted exercise in addition to the other three behaviors. All trials used comparable TTM-tailored interventions and the full assessment to participants who were at risk for the behaviors at baseline. The participants were assessed also at 12 and 24 months follow up. A series of LCA and LTA analyses will sequentially address the specific aims of this proposal: (1) to examine progression through the stages of change for individual cancer- related risk behaviors; (2) to examine progression through the stages of change for multiple (i.e., pairs or three) behaviors; (3) to examine stages of change algorithms for multiple (pairs or three) behaviors, as well as the potential predictors for stage membership using multivariate statistical modeling techniques; (4) to compare the four risk behaviors in terms of the stage progressions; (5) to compare the applicability of different complementary analytical methods, including LCA and LTA, and manifest variable approaches in terms of understanding mechanisms of behavior change. The potential insights from this study may provide an empirical foundation for development of more effective, low cost, tailored interventions for multiple risk behaviors and determine the potential LCA/LTA has as an alternative analytical framework in examining behavior change, as well as advancing the science of cancer prevention.

The objective of this proposal is to plan the development of a large-scale implementation of water quality sensors at the residential level and to develop a network of sensors using an Internet-of-Things (IOT) approach. Low sensor costs and their easy integration with personal devices such as cell phones and tablets open new opportunities for the development of novel approaches to measure water quality at the household level and increase consumer confidence. The proposed IOT network also will allow the community to gather crowdsourced geo data across towns and districts to locate and ultimately solve the water quality issues in the water distribution networks.
Five planning activities are proposed: 1) Collect information about available drinking water sensors to be deployed at the community level; 2) Evaluate the development of a smartphone-based Internet-of-Things system for water sensors; 3) Determine water quality perceptions nationwide; 4) Determine the willingness to adopt the sensor and network by users in different communities; 5) Engage water utilities, private well owners and other water innovation organizations with end-users (residents) to form a smart community that will have a potential to support crowdsourcing the water quality data. During this planning proposal, our team will collect data from multiple sources to propose a research strategy and to select a community for pilot testing. Simultaneously, we will identify perceptions, attitudes, behaviors and demographic aspects that could affect not only the willingness to use the sensor but also other barriers for widespread community adoption. Finally, we will identify facilities, resources and expertise that will support the successful performance of the future research. This project connects researchers from engineering, social and behavioral sciences to solve complex problems affecting our society such as insuring safe drinking water in times of decaying infrastructure.

In order to orchestrate the intelligence of sensing and user interaction on smartphones for water application, it is essential to understand the requirements of the stakeholders both in the water management team and residents. Hence, we will take a participatory design approach and interact with these stakeholders periodically to conduct surveys and acquire their feedback on their needs. This will also lead us to profile the user's capabilities to use smartphones and other portable technologies such as water quality sensors. This will determine the level of willingness of users to adopt the proposed technology. Accordingly, we will design and develop the app user interfaces using design-thinking processes that will meet the needs and capabilities of end users. Additionally, we will determine the best methodologies to propose a full-scale study in one of the communities selected for this planning stage. The research team combined expertise will be able to address both social and technological aspects for the development of a smart and connected community. Supporting the community engagement efforts, New England Water and Environment Association will facilitate the communication and activities coordination between the research group and private well owners as well as water facilities. Through the two proposed workshops the research team will develop the conceptual framework for the future full proposal including the needs and concerns of the community. Additionally, they will be able to identify facilities, resources and expertise that support the successful performance of the research effort in the community.