O conhecimento sobre mudanca de comportamento constitui importante ferramenta para auxiliar profi... more O conhecimento sobre mudanca de comportamento constitui importante ferramenta para auxiliar profissionais de saude a otimizar a eficacia das intervencoes com pacientes. Apesar das evidencias sobre a efetividade das atuacoes em saude de Agentes Comunitarios de Saude (ACS), esses ainda nao estao diretamente envolvidos nos programas de cessacao de uso de tabaco. Os objetivos deste estudo foram desenvolver e avaliar uma capacitacao de ACS para servirem de apoio a mulheres no processo de cessacao. A capacitacao foi elaborada em colaboracao com ACS, pacientes e profissionais de saude e enfocou no controle do tabaco e habilidades de mudanca do comportamento. Foram aplicados pre e pos-teste para avaliar o conhecimento sobre tabaco e mudanca de comportamento e percepcao sobre habilidades e confianca para promover mudancas de comportamento, sendo os dados analisados por meio do teste T pareado. Os resultados indicaram aquisicao de conhecimento e melhora na percepcao de habilidades e confianca...
The purpose of this article is to describe the development of a theory-based, culturally and gend... more The purpose of this article is to describe the development of a theory-based, culturally and gender-relevant Community Health Worker (CWH)-led tobacco cessation intervention for low-income Brazilian women who augments the tobacco cessation program offered through the public health system using Intervention Mapping (IM). We began with the establishment of a network of representatives from different segments of society followed by comprehensive needs assessments. We then established a logical planning process that was guided by a theoretical framework (Social Cognitive Theory) and existing evidence-based tobacco cessation programs, taking into account socio-political context of a universal health care system. Given the gender-relevance of our intervention and the importance of social support in tobacco cessation among women, we chose an intervention that would be delivered within the public health system but augmented by CHWs that would be trained in behavior change by researchers. On...
There is an increased need for capacity building of researchers and professionals in low- and mid... more There is an increased need for capacity building of researchers and professionals in low- and middle-income countries with evidence-based approaches across the tobacco control continuum, particularly with regard to gender-relevant strategies. We describe the development, implementation, and evaluation of a Career Development and Research Training Program (CDRTP) in tobacco control. The CDRTP is organized into two modules: Module I is open to the public and provides an overview of tobacco control; Module II, consists of a one-year program with multi-mode sessions toward the development of a pilot research project. Activities are implemented through co-learning to facilitate cross-fertilization of knowledge, collaborations, and team science. Between 2010 and 2015, 255 individuals participated in Module I with 57 applying for Module II's selective process. Out of these, 35 were selected, 29 completed the program (83%), 21 submitted pilot research projects that have undergone review, and 16 were approved for funding. Pre- and post-tests among the 29 participants who completed the training indicated improvement in scholars' perceived knowledge and skills on all of the components. In addition to attracting researchers and professionals who have not been working in tobacco control, the capacity building program has promoted knowledge, skills, and confidence among participants to pursue gender-relevant tobacco control research.
Cadernos de saúde pública / Ministério da Saúde, Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública
This study aimed to estimate the prevalence of tobacco use and to describe the demographic profil... more This study aimed to estimate the prevalence of tobacco use and to describe the demographic profile of female smokers in Paraná State, Brazil. The study used a cross-sectional population-based design with cluster sampling (n = 2,153) of women 18 years or older in seven cities. Prevalence of smoking was 13.4%, ranging from 10% in Cascavel to 19% in Irati. According to multivariate analysis, city of residence, marital status, and schooling were significantly associated with tobacco use. Women in Irati (OR = 2.08; 95%CI: 1.22-3.54) were more likely to smoke than those in Cambé. Married women and widows were less likely to smoke (OR = 0.47; 95%CI: 0.30-0.73 and OR = 0.43; 95%CI: 0.22-0.87) than single women. Women living with a partner (but not married) were more likely to smoke than single women (OR = 2.49; 95%CI: 1.12-5.53), and women with university degrees were less likely to smoke than those with eight years of school or less (OR = 0.41; 95%CI: 0.22-0.87). The results confirm the ne...
O conhecimento sobre mudanca de comportamento constitui importante ferramenta para auxiliar profi... more O conhecimento sobre mudanca de comportamento constitui importante ferramenta para auxiliar profissionais de saude a otimizar a eficacia das intervencoes com pacientes. Apesar das evidencias sobre a efetividade das atuacoes em saude de Agentes Comunitarios de Saude (ACS), esses ainda nao estao diretamente envolvidos nos programas de cessacao de uso de tabaco. Os objetivos deste estudo foram desenvolver e avaliar uma capacitacao de ACS para servirem de apoio a mulheres no processo de cessacao. A capacitacao foi elaborada em colaboracao com ACS, pacientes e profissionais de saude e enfocou no controle do tabaco e habilidades de mudanca do comportamento. Foram aplicados pre e pos-teste para avaliar o conhecimento sobre tabaco e mudanca de comportamento e percepcao sobre habilidades e confianca para promover mudancas de comportamento, sendo os dados analisados por meio do teste T pareado. Os resultados indicaram aquisicao de conhecimento e melhora na percepcao de habilidades e confianca...
The purpose of this article is to describe the development of a theory-based, culturally and gend... more The purpose of this article is to describe the development of a theory-based, culturally and gender-relevant Community Health Worker (CWH)-led tobacco cessation intervention for low-income Brazilian women who augments the tobacco cessation program offered through the public health system using Intervention Mapping (IM). We began with the establishment of a network of representatives from different segments of society followed by comprehensive needs assessments. We then established a logical planning process that was guided by a theoretical framework (Social Cognitive Theory) and existing evidence-based tobacco cessation programs, taking into account socio-political context of a universal health care system. Given the gender-relevance of our intervention and the importance of social support in tobacco cessation among women, we chose an intervention that would be delivered within the public health system but augmented by CHWs that would be trained in behavior change by researchers. On...
There is an increased need for capacity building of researchers and professionals in low- and mid... more There is an increased need for capacity building of researchers and professionals in low- and middle-income countries with evidence-based approaches across the tobacco control continuum, particularly with regard to gender-relevant strategies. We describe the development, implementation, and evaluation of a Career Development and Research Training Program (CDRTP) in tobacco control. The CDRTP is organized into two modules: Module I is open to the public and provides an overview of tobacco control; Module II, consists of a one-year program with multi-mode sessions toward the development of a pilot research project. Activities are implemented through co-learning to facilitate cross-fertilization of knowledge, collaborations, and team science. Between 2010 and 2015, 255 individuals participated in Module I with 57 applying for Module II's selective process. Out of these, 35 were selected, 29 completed the program (83%), 21 submitted pilot research projects that have undergone review, and 16 were approved for funding. Pre- and post-tests among the 29 participants who completed the training indicated improvement in scholars' perceived knowledge and skills on all of the components. In addition to attracting researchers and professionals who have not been working in tobacco control, the capacity building program has promoted knowledge, skills, and confidence among participants to pursue gender-relevant tobacco control research.
Cadernos de saúde pública / Ministério da Saúde, Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública
This study aimed to estimate the prevalence of tobacco use and to describe the demographic profil... more This study aimed to estimate the prevalence of tobacco use and to describe the demographic profile of female smokers in Paraná State, Brazil. The study used a cross-sectional population-based design with cluster sampling (n = 2,153) of women 18 years or older in seven cities. Prevalence of smoking was 13.4%, ranging from 10% in Cascavel to 19% in Irati. According to multivariate analysis, city of residence, marital status, and schooling were significantly associated with tobacco use. Women in Irati (OR = 2.08; 95%CI: 1.22-3.54) were more likely to smoke than those in Cambé. Married women and widows were less likely to smoke (OR = 0.47; 95%CI: 0.30-0.73 and OR = 0.43; 95%CI: 0.22-0.87) than single women. Women living with a partner (but not married) were more likely to smoke than single women (OR = 2.49; 95%CI: 1.12-5.53), and women with university degrees were less likely to smoke than those with eight years of school or less (OR = 0.41; 95%CI: 0.22-0.87). The results confirm the ne...
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Papers by Lorna Bittencourt