The Science Journal of the American Association for Respiratory Care

2007 OPEN FORUM Abstracts

READINESS TO QUIT SMOKING AND BEGIN PHYSICAL ACTIVITY AMONG A SAMPLE OF PATIENTS SEEKING NON-EMERGENT CARE IN AN URBAN, ACADEMIC, TERTIARY CARE HEALTH SCIENCE CENTER

D. D. Simpson1, M. E. Anders1, L. W. Turner2, T. M. Holmes1, H. J. Spencer1

Background: Relationships between cardiopulmonary disease and modifiable risk factors such as tobacco use and lack of exercise are known, though understanding the health practices of patients seeking non-emergent care in urban, academic, tertiary care health science centers is lacking. This study presents characteristics of emergency department (ED) patients and their readiness to change in the areas of smoking cessation and physical activity using the transtheoretical model for behavior change.

Method:
Based on sample size calculations, a random selection of days across a seven-month time period was performed and sampling clusters created. Consecutive ED patients aged 18 years or older were consented to participate and interviewed. SPSS v.13 was used for data entry and analysis. Descriptive statistics were generated and multivariable regression analysis performed. The level of significance was set at alpha = 0.01.

Results:
This study included 253 patients (94% response rate) whose ages ranged from 18 to 93 years (mean = 43.08, SD: ± 17.19). The sample contained more female (59.3%) than male and more white (54.5%) than black patients. The majority did not exercise (81%), had an education of high school or less (78.7%), described their overall health status as poor (56.9%), lacked insurance (55.7%) and smoked tobacco (54.9%). Many lacked access to primary care (45.8%) and used the ED as their usual source of care (32.0%). Though some patients did not intend to stop smoking (18.5%) or start exercising (43.9%), others were in the preparation or action stage for physical activity (19.3%) and smoking cessation (28.5%) [See Table]. The final model for exercise self-efficacy included only age (OR = 1.47, 95% CI: 1.24, 1.75) as an independent variable (p<0.001).

Conclusions:
Among patients that smoked, almost three-quarters reported a desire to participate in a smoking cessation program; yet, none were referred. Targeted smoking cessation interventions for patients based on their stage of change are warranted. Studies focusing on smoking and exercise self-efficacy and the impact of tobacco cessation programs among adults and parents of children seeking non-emergent care are also needed.

Readiness to Change in the Areas of Smoking Cessation and Physical Activity (n = 253)
Area of Change Stage of Readiness to Change
 Precontemplation Contemplation Preparation Action Maintenance Never Smoked
Smoking 47 (18.5%) 48 (19.0%) 45 (17.8%) 27 (10.7%) 35 (13.8%) 51 (20.2%)
Physical Activity 111 (43.9%) 58 (22.9%) 36 (14.2%) 13 (5.1%) 35 (13.8%)  



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