Background on Individual Education
What are individual education strategies?
- Strategies that work to reduce tobacco use initiation (smoking and smokeless tobacco products), increase cessation of tobacco use, and reduce exposure to environmental tobacco smoke by altering attitudes and beliefs about tobacco use as well as enhancing individual knowledge and skills.
- Your intervention may focus specifically on helping people to do one or more of the following: avoid the temptation to start using tobacco by discussing the harmful effects; quit using tobacco by providing information, motivation, skill-building opportunities and support, address barriers to quitting or help people to develop strategies to overcome barriers; prevent the urge to go back to using tobacco once they have quit (relapse prevention); or keep away from specific environments in order to minimize exposure to environmental tobacco smoke.
How can I use individual education strategies in tobacco interventions?
- The specific strategies used to provide information differ based on the focus of the intervention. For example, information may be provided through individual counseling sessions or self-help materials such as newsletters, brochures, posters, fact sheets, videos, or websites. Other strategies may provide cues to action (e.g., a calendar prompting the individual to enter the number of days without using tobacco) rather than education to specifically increase knowledge about tobacco use. These strategies are designed to provide information to individuals (e.g., one way communication such as through a brochure).
- The content of the message may focus on a wide variety of materials, including: information (e.g., short and long term benefits of avoiding or quitting tobacco use, relationship of tobacco use to health and quality of life), recommendations (e.g., how to stop using tobacco, how to deal with barriers to quitting), resources (e.g., health education classes, support groups) or skill-building exercises (e.g., how to respond to stress without using tobacco).
How do “tailored messages” and “targeted messages” differ? How can I use these messages in tobacco interventions?
- Individual education interventions may work best when information is matched to the individual. “Tailored messages” take into account specific individual characteristics in creating a tobacco use message designed for the individual. Materials or strategies may be developed specifically to meet an individual’s characteristics in terms of readiness to change, attitudes, beliefs, current tobacco use behaviors and other lifestyle characteristics. The concept of readiness to change (drawn from the Transtheoretical Model or Stages of Change) suggests that individuals may need different kinds of interventions to help them address tobacco use depending on how ready they are to change their behaviors. For example, some tobacco users may not have even considered quitting while others may have thought about quitting but don’t know how to begin. Others may have had several quit attempts but still have not successfully been able to stop using tobacco.
- Tailored health education materials are developed based on characteristics that are unique to each individual; therefore, an individual assessment (e.g., survey, interview) is required in order to collect information specific to the individual.
- Alternately, other materials or strategies may be geared toward a specific subgroup of the population of interest (e.g., pregnant women). These are often called “targeted messages” because they consider the specific needs of this subpopulation. In a similar manner, these strategies can be used to influence groups of people (e.g., encourage targeted population to cease smoking for the health of their fetus) but the messages are not specific to each individual.
What is an example of a tailored message?
- A recommendation to quit smoking may take into account the following information about the individual: Rachel, a twenty year old computer programmer smokes two packs of cigarettes a day and has been thinking about quitting over the last two weeks. Her reasons for and against quitting smoking have to do with her physical appearance. She believes that quitting will decrease the yellowing of her nails and fingertips, and might help decrease her chances of getting wrinkles. That said, she is also really worried about gaining weight. While Rachel knows that in the long run smoking may impair her health, she does not really see that as a significant issue to worry about at the moment.
- A message can be designed for Rachel as follows: “Congratulations Rachel! Thinking about quitting is the first step to becoming a non-smoker. Quitting smoking can have a number of immediate positive effects. For example, the yellow in your fingernails and fingertips will go away within a few weeks. The smell of tobacco on your clothes and furniture will also start to disappear. As you know, smoking can increase your facial wrinkles and quitting now can really help. You can start by cutting down today. Keep reading to find out some specific tips you might find helpful in allowing you to cut down without gaining weight by watching what you eat and increasing your physical activity.”
What is self management and how can I use it in tobacco interventions?
- Another common individual education approach is to build the skills to change behavior through self-management. Self-management takes individuals through a process of identifying an issue (smoking), assessing their routine through self monitoring (keeping track of when you smoke the most, when you have the greatest cravings, etc.), making sense of your routine (what is happening that increases your cravings), identifying and setting a goal, contracting a change, developing an action plan to achieve the goal (including how to overcome barriers), developing specific skills to overcome these barriers and achieve the goal (e.g., developing alternative coping skills in general and specifically around what to do when experiencing tobacco cravings) and rewarding changes as they are made.
What are “stages of change” and why are they important in tobacco interventions?
- Previous work has shown that individuals go through different stages of readiness to change behavior and that different types of interventions can help individuals move from one stage to the next. For example, if people are not really thinking about quitting (pre-contemplation), the informational strategies described above may be particularly helpful in getting them to begin to think about quitting (contemplation). However, as individuals begin to get ready to change (preparation), providing self-management techniques and skill building may help them begin to take steps toward quitting (action).
What is skill building and how can it be used in tobacco interventions?
- Skill building strategies can be tailored to individuals or targeted to the population of interest. Both tailored and targeted strategies can be delivered once or at regular intervals (e.g., weekly, monthly or quarterly) and appear in the form of print, telephone, audio, video or computer kiosk messages. They may be conducted on their own or in combination with other intervention activities (e.g., enhancing support for non-smoking or creating policies to reduce exposure to environmental tobacco smoke).
What else do I need to consider for tobacco interventions?
- Some studies describe advantages of an interactive, web-based tailored intervention over a more traditional print version, including: the ability to receive immediate feedback, an interactive nature similar to interpersonal counseling, and the ability to use graphics and other features to increase interest and attention. Furthermore, once on the web, the tailored intervention can reach a relatively larger group of people making it more cost-effective. In addition, it can be updated continuously to include the most recent knowledge.