Thomas Kirchner
Thomas Kirchner
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Associate Professor of Social and Behavioral Sciences
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Professional overview
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Dr. Thomas Kirchner is a clinical-health psychologist and methodologist interested in the analysis and graphical representation of longitudinal and geographic data, including methodologies that link individual behavior to the real-time context in which it occurs. Dr. Kirchner’s research targets momentary influences on the maintenance of health-related behavior utilizing both field-based (ecological momentary assessment) and laboratory-based paradigms. These geographic information systems and analytical methods can then inform public health, research, and policy.
As the Director and Principal Investigator of the mHealth (mobile health) Lab, Dr. Kirchner uses GIS to understand health-related behavior and decision-making in real time (e.g., how people make decisions about what they eat and drink, the places they go to exercise in their neighborhoods, the amount of time they spend outdoors, and whether they smoke cigarettes and/or marijuana). In the Lab, students apply mHealth tools to explore geospatial systems, technology, research, and community advocacy. Students learn how to leverage the power of their cell phones to collect data about neighborhoods and experiences.
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Education
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MS, Clinical and Biological/Health Psychology, University of Pittsburgh, Pittsburgh, PAPhD, Clinical and Biological/Health Psychology, University of Pittsburgh, Pittsburgh, PA
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Areas of research and study
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Behavioral Determinants of HealthGeographic Information Science (GIS)Geographically-explicit EMALongitudinal Data AnalysisSocial BehaviorsUrban InformaticsUrban Science
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Publications
Publications
Effects of alcohol on group formation among male social drinkers
AbstractKirchner, T., Sayette, M. A., Cohn, J. F., Moreland, R. L., & Levine, J. M. (n.d.).Publication year
2006Journal title
Journal of Studies on AlcoholVolume
67Issue
5Page(s)
785-793AbstractObjective: Social factors affect alcohol use and misuse, yet researchers rarely study the acute effects of alcohol in groups. This study used systematic observation techniques to measure the effects of alcohol on behavioral responses during an initial group interaction. Method: Fifty-four male social drinkers were assembled into three-person groups of strangers, and all members of each group were administered either a 0.82 g/kg dose of alcohol or a placebo to be consumed during a 30-minute period. This social interaction was video recorded, and the duration and sequence of selected smiling and speech behaviors were coded on a 1-second time base. Results: Alcohol consumption increased individual- and group-level coordination of smiling and speech behaviors over time and improved self-reported bonding. Conclusions: These data suggest that alcohol may facilitate social bonding during initial group formation. Measuring behavioral responses in a social context provides new directions for studying the acute effects of alcohol.Effects of alcohol on risk-seeking behavior : A group-level analysis
AbstractSayette, M. A., Kirchner, T., Moreland, R. L., Levine, J. M., & Travis, T. (n.d.).Publication year
2004Journal title
Psychology of Addictive BehaviorsVolume
18Issue
2Page(s)
190-193AbstractAlthough much drinking occurs in social settings, there has been little testing of alcohol in groups. The authors examined the effects of alcohol on performance on a group decision-making task. Fifty-four unacquainted male social drinkers were randomly assigned to 3-person groups that consumed either alcohol (0.82 g/kg) or a placebo. After drinking, participants decided whether to complete a 30-min questionnaire battery or toss a coin and, pending the outcome of that toss, complete either no questionnaires or a 60-min battery. Alcohol groups were significantly more likely than placebo groups to choose the coin toss. Results highlight the potent effects of alcohol on group decision making and suggest that application of social psychological theory and methods to the study of alcohol is warranted.Effects of smoking abstinence and alcohol consumption on smoking-related outcome expectancies in heavy smokers and tobacco chippers
AbstractKirchner, T., & Sayette, M. A. (n.d.).Publication year
2007Journal title
Nicotine and Tobacco ResearchVolume
9Issue
3Page(s)
365-376AbstractSmoking cessation interventions often target expectancies about the consequences of smoking. Yet little is known about the way smoking-related expectancies vary across different contexts. Two internal contexts that are often linked with smoking relapse are states associated with smoking abstinence and alcohol consumption. This report presents a secondary analysis of data from two experiments designed to examine the influence of smoking abstinence, and smoking abstinence combined with alcohol consumption, on smoking-related outcome expectancies among heavy smokers and tobacco chippers (smokers who had consistently smoked no more than 5 cigarettes/day for at least 2 years). Across both experiments, smoking abstinence and alcohol consumption increased expectancies of positive reinforcement from smoking. In addition, alcohol consumption increased negative reinforcement expectancies among tobacco chippers, such that the expectancies became more similar to those of heavy smokers as tobacco chippers' level of subjective alcohol intoxication increased. Findings suggest that these altered states influence the way smokers evaluate the consequences of smoking, and provide insight into the link between smoking abstinence, alcohol consumption, and smoking behavior.Effects of smoking urge on temporal cognition
AbstractSayette, M. A., Loewenstein, G., Kirchner, T., & Travis, T. (n.d.).Publication year
2005Journal title
Psychology of Addictive BehaviorsVolume
19Issue
1Page(s)
88-93AbstractThe authors examined temporal aspects of smoking urge. In Experiment 1, smokers assigned to high- or low-urge conditions were informed they would be allowed to smoke in 2.5 min. They next completed measures of time perception. High-urge smokers reported 45 s to pass significantly more slowly than did low-urge smokers. In Experiment 2, the high-urge smokers from Experiment 1 anticipated that their urges would climb steadily over the next 45 min if they were not permitted to smoke. Another group of high-urge smokers actually reported their urges over 45 min. These urge ratings did not show the steady rise anticipated by the first group. Results suggest that smoking urge may affect time perception and that craving smokers overpredict the duration and intensity of their own future smoking urges if they abstain.Electronic cigarette advertising at the point-of-sale : A gap in tobacco control research
AbstractGanz, O., Cantrell, J., Moon-Howard, J., Aidala, A., Kirchner, T., & Vallone, D. (n.d.).Publication year
2015Journal title
Tobacco controlVolume
24Issue
E1Page(s)
e110-e112Abstract~Electronic cigarettes as a harm reduction strategy among patients with COPD : protocol for an open-label two arm randomized controlled pilot trial
AbstractStevens, E. R., Lei, L., Cleland, C. M., Vojjala, M., El-Shahawy, O., Berger, K. I., Kirchner, T., & Sherman, S. E. (n.d.).Publication year
2022Journal title
Addiction Science and Clinical PracticeVolume
17Issue
1AbstractBackground: Smoking cessation is the most effective means of slowing the decline of lung function associated with chronic obstructive pulmonary disease (COPD). While effective smoking cessation treatments are available, they are underutilized and nearly half of people with COPD continue to smoke. By addressing both nicotine and behavioral dependence, electronic cigarettes (EC) could help people with COPD reduce the harm of combustible cigarettes (CC) through reductions in number of Cigarettes per Day (CPD) or quitting CC completely. The purpose of this pilot study is to identify barriers and facilitators to the use of and assess the preliminary effectiveness of EC as a harm reduction strategy among people with COPD. Methods: In an open-label two-arm randomized controlled trial pilot study, 60 patients identified as smokers with a COPD diagnosis via electronic health records from a large urban health center are randomized in a 1:1 ratio to either standard care [counseling + nicotine replacement therapy (NRT)] or counseling + EC. The NRT arm will receive nicotine patches and nicotine lozenges for 12 weeks. The EC arm will receive EC for 12 weeks. Both cohorts will receive counseling from a licensed mental health counselor. Using ecological momentary assessment, participants will report their use of CC in both arms and EC use in the EC arm daily via text message. Primary outcomes will be feasibility and acceptability of intervention, and secondary outcomes will be reduction in CPD and change in COPD symptoms as measured by COPD Assessment Tool (CAT) score at 12-weeks. EC displacement of CC. To explore attitudes towards the use of EC as a harm-reduction strategy for patients with COPD, interviews will be performed with a sample of participants from both study arms. Discussion: Despite decades of availability of smoking cessation medications, nearly half of people with COPD still smoke. This study aims to address the unmet need for feasible and effective strategies for reducing CC use among those with COPD, which has the potential to significantly improve the health of people with COPD who smoke. Trial Registration ClinicalTrials.gov Identifier: NCT04465318.Flavored cigar smoking among African American young adult dual users : An ecological momentary assessment
AbstractChen-Sankey, J. C., Choi, K., Kirchner, T., Feldman, R. H., Butler, J., & Mead, E. L. (n.d.).Publication year
2019Journal title
Drug and alcohol dependenceVolume
196Page(s)
79-85AbstractBackground: Flavored cigar sales have increased in recent years in the U.S. African American young adults (AAYAs) have high prevalence of smoking flavored cigars and dual use with cigarettes, but the predictors of use are unclear. We examined the predictors of flavored cigar smoking among AAYA dual users. Methods: We analyzed data from an Ecological Momentary Assessment (EMA) study that captured near real-time affect, smoking cues, and tobacco smoking from eight text-messaging surveys per day over two weeks. Sixty-three AAYA (ages 18–29) dual users of cigarettes and cigars recorded 1205 cigar smoking moments. Multivariable Generalized Estimating Equations were used to assess the predictors of smoking cigars with flavors and specific flavor types. Results: Half of the participants were women (49.2%) and aged between 18–24 (46.7%). Over the two-weeks, almost all (98.4%) participants smoked flavored cigars, and 64.2% of the cigars smoked were flavored. Alcohol (34.4%) was the most frequently smoked flavor type followed by sweet (23.4%) and mint (5.7%). Feeling stressed (AOR = 1.07) and bored (AOR = 1.10) predicted smoking alcohol flavors. Blunt smoking positively predicted smoking sweet flavors (AOR = 4.79), but negatively predicted smoking alcohol flavors (AOR = 0.40). Conclusions: Smoking flavored cigars, especially alcohol-flavored cigars, was prevalent among AAYA dual users in this study. This group might use specific flavors for different purposes including smoking blunts and boosting mood. Efforts to reduce cigar use need to tackle these risk factors and the increased marketing and low-cost pricing of cigars. A federal ban of cigar flavors might reduce the appeal of cigar products.Geospatial exposure to point-of-sale tobacco : Real-time craving and smoking-cessation outcomes
AbstractKirchner, T., Cantrell, J., Anesetti-Rothermel, A., Ganz, O., Vallone, D. M., & Abrams, D. B. (n.d.).Publication year
2013Journal title
American journal of preventive medicineVolume
45Issue
4Page(s)
379-385AbstractBackground: Little is known about the factors that drive the association between point-of-sale marketing and behavior, because methods that directly link individual-level use outcomes to real-world point-of-sale exposure are only now beginning to be developed. Purpose: Daily outcomes during smoking cessation were examined as a function of both real-time geospatial exposure to point-of-sale tobacco (POST) and subjective craving to smoke. Methods: Continuous individual geospatial location data collected over the first month of a smoking-cessation attempt in 2010-2012 (N=475) were overlaid on a POST outlet geodatabase (N=1060). Participants' mobility data were used to quantify the number of times they came into contact with a POST outlet. Participants recorded real-time craving levels and smoking status via ecological momentary assessment (EMA) on cellular telephones. Results: The final data set spanned a total of 12,871 days of EMA and geospatial tracking. Lapsing was significantly more likely on days with any POST contact (OR=1.19, 95% CI=1.18, 1.20), and increasingly likely as the number of daily POST contacts increased (OR=1.07, 95% CI=1.06, 1.08). Overall, daily POST exposure was significantly associated with lapsing when craving was low (OR=1.22, 95% CI=1.20, 1.23); high levels of craving were more directly associated with lapse outcomes. Conclusions: These data shed light on the way mobility patterns drive a dynamic interaction between individuals and the POST environment, demonstrating that quantification of individuals' exposure to POST marketing can be used to identify previously unrecognized patterns of association among individual mobility, the built environment, and behavioral outcomes.Implementation of a multimodal mobile system for point-of-sale surveillance : Lessons learned from case studies in washington, dc, and new york city
AbstractCantrell, J., Ganz, O., Ilakkuvan, V., Tacelosky, M., Kreslake, J., Moon-Howard, J., Aidala, A., Vallone, D., Anesetti-Rothermel, A., & Kirchner, T. (n.d.).Publication year
2015Journal title
JMIR Public Health and SurveillanceVolume
1Issue
2AbstractBackground: In tobacco control and other fields, point-of-sale surveillance of the retail environment is critical for understanding industry marketing of products and informing public health practice. Innovations in mobile technology can improve existing, paper-based surveillance methods, yet few studies describe in detail how to operationalize the use of technology in public health surveillance. Objective: The aims of this paper are to share implementation strategies and lessons learned from 2 tobacco, point-of-sale surveillance projects to inform and prepare public health researchers and practitioners to implement new mobile technologies in retail point-of-sale surveillance systems. Methods: From 2011 to 2013, 2 point-of-sale surveillance pilot projects were conducted in Washington, DC, and New York, New York, to capture information about the tobacco retail environment and test the feasibility of a multimodal mobile data collection system, which included capabilities for audio or video recording data, electronic photographs, electronic location data, and a centralized back-end server and dashboard. We established a preimplementation field testing process for both projects, which involved a series of rapid and iterative tests to inform decisions and establish protocols around key components of the project. Results: Important components of field testing included choosing a mobile phone that met project criteria, establishing an efficient workflow and accessible user interfaces for each component of the system, training and providing technical support to fieldworkers, and developing processes to integrate data from multiple sources into back-end systems that can be utilized in real-time. Conclusions: A well-planned implementation process is critical for successful use and performance of multimodal mobile surveillance systems. Guidelines for implementation include (1) the need to establish and allow time for an iterative testing framework for resolving technical and logistical challenges; (2) developing a streamlined workflow and user-friendly interfaces for data collection; (3) allowing for ongoing communication, feedback, and technology-related skill-building among all staff; and (4) supporting infrastructure for back-end data systems. Although mobile technologies are evolving rapidly, lessons learned from these case studies are essential for ensuring that the many benefits of new mobile systems for rapid point-of-sale surveillance are fully realized.Indicators of dependence for different types of tobacco product users : Descriptive findings from Wave 1 (2013–2014) of the Population Assessment of Tobacco and Health (PATH) study
AbstractStrong, D. R., Pearson, J., Ehlke, S., Kirchner, T., Abrams, D. S., Taylor, K., Compton, W. M., Conway, K. P., Lambert, E., Green, V. R., Hull, L. C., Evans, S. E., Cummings, K. M., Goniewicz, M., Hyland, A., & Niaura, R. S. (n.d.).Publication year
2017Journal title
Drug and alcohol dependenceVolume
178Page(s)
257-266AbstractBackground and aims With no established standard for assessing tobacco dependence (TD) across tobacco products in surveys, the Population Assessment of Tobacco and Health (PATH) Study provides a unique platform for examining the psychometric properties and validity of multiple indicators of tobacco dependence across a range of tobacco products. Participants A U.S. nationally representative sample from the 32,320 adult Wave 1 interviews with analyses focused on 14,287 respondents who were current established users of tobacco products. Findings This analysis confirms a single primary latent construct underlying responses to TD indicators for cigarettes, e-cigarettes, cigars, hookah, and smokeless tobacco products. Mutually exclusive past year tobacco-user groups included: cigarette only (n = 8689), e-cigarette only (n = 437), cigar only (traditional, cigarillo, or filtered) (n = 706), hookah only (n = 461), smokeless tobacco only (n = 971), cigarette plus e-cigarette (n = 709), and multiple tobacco product users (n = 2314). Differential Item Functioning (DIF) analyses supported use of 16 of the 24 examined TD indicators for comparisons across tobacco users. With cigarette users as a reference (mean = 0.0, SD = 1.0), we observed a range of TD with hookah (mean = −1.71) and cigar (mean = −1.92) only users being the lowest, and cigarette plus e-cigarette product users being the highest (mean = 0.35). Regression models including sociodemographic factors supported concurrent validity with increased product use frequency and TD among cigarette-only (p < 0.001), e-cigarette only (p < 0.002), cigar (p < 0.001), hookah only (p < 0.001), and smokeless tobacco users (p < 0.001). Conclusion The PATH Study Adult Wave 1 Questionnaire provided psychometrically valid measures of TD that enables future regulatory investigations of nicotine dependence across tobacco products.Individual Mobility and Uncertain Geographic Context : Real-time Versus Neighborhood Approximated Exposure to Retail Tobacco Outlets Across the US
AbstractKirchner, T., Gao, H., Lewis, D. J., Anesetti-Rothermel, A., Carlos, H. A., & House, B. (n.d.).Publication year
2019Journal title
Journal of Healthcare Informatics ResearchVolume
3Issue
1Page(s)
70-85AbstractThere is growing interest in the way exposure to neighborhood risk and protective factors affects the health of residents. Although multiple approaches have been reported, empirical methods for contrasting the spatial uncertainty of exposure estimates are not well established. The objective of this paper was to contrast real-time versus neighborhood approximated exposure to the landscape of tobacco outlets across the contiguous US. A nationwide density surface of tobacco retail outlet locations was generated using kernel density estimation (KDE). This surface was linked to participants’ (Np = 363) inferred residential location, as well as to their real-time geographic locations, recorded every 10 min over 180 days. Real-time exposure was estimated as the hourly product of radius of gyration and average tobacco outlet density (Nhour = 304, 164 h). Ordinal logit modeling was used to assess the distribution of real-time exposure estimates as a function of each participant’s residential exposure. Overall, 61.3% of real-time, hourly exposures were of relatively low intensity, and after controlling for temporal and seasonal variation, 72.8% of the variance among these low-level exposures was accounted for by residence in one of the two lowest residential exposure quintiles. Most moderate to high intensity exposures (38.7% of all real-time, hourly exposures) were no more likely to have been contributed by subjects from any single residential exposure cluster than another. Altogether, 55.2% of the variance in real-time exposures was not explained by participants’ residential exposure cluster. Calculating hourly exposure estimates made it possible to directly contrast real-time observations with static residential exposure estimates. Results document the substantial degree that real-time exposures can be misclassified by residential approximations, especially in residential areas characterized by moderate to high retail density levels.Individual mobility patterns and real-time geo-spatial exposure to point-of-sale tobacco marketing
AbstractKirchner, T., Cantrell, J., Anesetti-Rothermel, A., Pearson, J., Cha, S., Kreslake, J., Ganz, O., Tacelosky, M., Abrams, D. S., & Vallone, D. (n.d.).Publication year
2012AbstractHealth-related behaviors occur as part of a broad socio-ecological context that unfolds dynamically over time. Yet systematic quantification of the way individuals come into contact with health-related features in their local environment remains a difficult challenge. Doing so requires a multi-tiered approach that integrates both individual geo-location data and comprehensive community-level information about health-related features in the local built environment. This report describes the implementation of a system for quantification of real-time exposure to point-of-sale tobacco marketing via mobile phone geo-location tracking. Individual mobility patterns from a longitudinal cohort of DC residents (N=486) were overlaid on an existing community-level point-of-sale surveillance geodatabase (N=1,080 stores). Participants were DC residents who carried a geolocation tracking device over the first 8-weeks of a smoking cessation attempt. Tracking data were then used to produce a mobility "signature," physically linking each person to their surrounding point-of-sale marketing environment in real-time. Results demonstrate the dynamic nature of an individuals' experience of the point-of-sale environment. We identify substantial between-person differences in tobacco product pricing exposure, and find that these correspond to clusters of individuals whose price exposures vary systematically over time of day. These data suggest that perceptions of the point-of-sale environment as relatively static fail to account for the mobility and preferences of individuals as they actively engage with their neighborhoods over time.Initiation, continuation of use and cessation of alternative tobacco products among young adults : A qualitative study
AbstractVu, M., Getachew, B., Payne, J. B., Kirchner, T., & Berg, C. J. (n.d.).Publication year
2018Journal title
Tobacco Prevention and CessationVolume
4Issue
FebruaryAbstractINTRODUCTION Diverse non-cigarette alternative tobacco products are increasingly popular in the United States. This study investigates the reasons why young adults initiate and continue the use of these products, as well as potential motivations and approaches for quitting. Products assessed include cigarettes, little cigars/cigarillos (LCCs), smokeless tobacco, e-cigarettes, and hookahs. METHODS We conducted 60 telephone interviews, of 30-minute duration, with tobacco users enrolled in colleges in Georgia. Qualitative analysis was used to identify themes emerging from the data. RESULTS Reasons for initiation, continued use, and (potential) cessation showed similarities and differences across products. Most commonly cited reasons for initiation included: peer influence (all products), flavors/tastes (all products except cigarettes), and easy environmental access and/or low costs (LCCs, smokeless tobacco, and e-cigarettes). Participants discussed several influences on continued use, such as peer influence (cigarettes, LCCs, and hookahs), stress management (all products except hookahs), and use with other substances (cigarettes, LCCs, and hookahs). Primary motivations for cessation mentioned by participants were family responsibilities (cigarettes, e-cigarettes, and hookahs) and health concerns (all products except e-cigarettes). Frequently used cessation strategies included avoidance of other tobacco users (cigarettes, LCCs, and hookahs) and a reduction of nicotine intake (cigarettes and e-cigarettes). CONCLUSIONS Our findings suggest that researchers should consider the differences in reasons for use and discontinued use of tobacco products in order to develop targeted messaging strategies, particularly noting the differential impact of interpersonal influences and health concerns.Longitudinal human mobility and real-time access to a national density surface of retail outlets
AbstractKirchner, T., Gao, H., Anesetti-Rothermel, A., Carlos, H., & House, B. (n.d.).Publication year
2014Journal title
ACM Urban ComputingAbstract~Marketing little cigars and cigarillos : Advertising, price, and associations with neighborhood demographics
AbstractCantrell, J., Kreslake, J. M., Ganz, O., Pearson, J. L., Vallone, D., Anesetti-Rothermel, A., Xiao, H., & Kirchner, T. (n.d.).Publication year
2013Journal title
American journal of public healthVolume
103Issue
10Page(s)
1902-1909AbstractObjectives. We have documented little cigar and cigarillo (LCC) availability, advertising, and price in the point-of-sale environment and examined associations with neighborhood demographics. Methods. We used a multimodal real-time surveillance system to survey LCCs in 750 licensed tobacco retail outlets that sold tobacco products in Washington, DC. Using multivariate models, we examined the odds of LCC availability, the number of storefront exterior advertisements, and the price per cigarillo for Black & Mild packs in relation to neighborhood demographics. Results. The odds of LCC availability and price per cigarillo decreased significantly in nearly a dose-response manner with each quartile increase in proportion of African Americans. Prices were also lower in some young adult neighborhoods. Having a higher proportion of African American and young adult residents was associated with more exterior LCC advertising. Conclusions. Higher availability of LCCs in African American communities and lower prices and greater outdoor advertising in minority and young adult neighborhoods may establish environmental triggers to smoke among groups susceptible to initiation, addiction, and long-term negative health consequences.Momentary measurements and chronic conditions
AbstractKirchner, T., & Gao, H. (n.d.).Publication year
2020Journal title
Health and PlaceVolume
64Abstract~National enforcement of the Family Smoking Prevention and Tobacco Control Act at point-of-sale
AbstractKirchner, T., Villanti, A. C., Tacelosky, M., Anesetti-Rothermel, A., Gao, H., Pearson, J. L., Ganz, O., Cantrell, J., Vallone, D., & Abrams, D. S. (n.d.).Publication year
2015Journal title
Tobacco Regulatory ScienceVolume
1Issue
1Page(s)
24-35Abstract~National Enforcement of the FSPTCA at Point-of-Sale
AbstractKirchner, T., Villanti, A. C., Tacelosky, M., Anesetti-rothermel, A., Gao, H., Pearson, J., Ganz, O., Cantrell, J., Vallone, D. M., & Abrams, D. B. (n.d.).Publication year
2015Journal title
Tobacco Regulatory ScienceVolume
1Issue
1Page(s)
24-35Abstract~Nicotine dependence, "background" and cue-induced craving and smoking in the laboratory
AbstractDunbar, M. S., Shiffman, S., Kirchner, T., Tindle, H. A., & Scholl, S. M. (n.d.).Publication year
2014Journal title
Drug and alcohol dependenceVolume
142Page(s)
197-203AbstractBackground: Nicotine dependence has been associated with higher "background" craving and smoking, independent of situational cues. Due in part to conceptual and methodological differences across past studies, the relationship between dependence and cue-reactivity (CR; e.g., cue-induced craving and smoking) remains unclear. Methods: 207 daily smokers completed six pictorial CR sessions (smoking, negative affect, positive affect, alcohol, smoking prohibitions, and neutral). Individuals rated craving before (background craving) and after cues, and could smoke following cue exposure. Session videos were coded to assess smoking. Participants completed four nicotine dependence measures. Regression models assessed the relationship of dependence to cue-independent (i.e., pre-cue) and cue-specific (i.e., pre-post cue change for each cue, relative to neutral) craving and smoking (likelihood of smoking, latency to smoke, puff count). Results: Dependence was associated with background craving and smoking, but did not predict change in craving across the entire sample for any cue. Among alcohol drinkers, dependence was associated with greater increases in craving following the alcohol cue. Only one dependence measure (Wisconsin Inventory of Smoking Dependence Motives) was consistently associated with smoking reactivity (higher likelihood of smoking, shorter latency to smoke, greater puff count) in response to cues. Conclusion: While related to cue-independent background craving and smoking, dependence is not strongly associated with laboratory cue-induced craving under conditions of minimal deprivation. Dependence measures that incorporate situational influences on smoking correlate with greater cue-provoked smoking. This may suggest independent roles for CR and traditional dependence as determinants of smoking, and highlights the importance of assessing behavioral CR outcomes.Patterns of intermittent smoking : An analysis using Ecological Momentary Assessment
AbstractShiffman, S., Kirchner, T., Ferguson, S. G., & Scharf, D. M. (n.d.).Publication year
2009Journal title
Addictive BehaviorsVolume
34Issue
6-7Page(s)
514-519AbstractNon-daily smokers comprise a substantial proportion of US smokers, but there has been little study of their patterns of smoking, which are often assumed to reflect "social smoking." We used Ecological Momentary Assessment methods to study smoking patterns in 27 non-daily smoking adults who recorded each cigarette smoked over three weeks by leaving a voice mail message indicating their circumstances at the time of smoking. All told, 689 cigarettes were recorded over 589 person-days of observation. On average, participants smoked on 67% of days, averaging 2.1 (SD = 0.91) cigarettes per day on days they smoked; 22% of all cigarettes were smoked in bouts (within an hour of another cigarette). Altogether, 19% of cigarettes were smoked when drinking alcohol and 29% when participants were socializing. Smoking patterns varied widely across participants. A pair of hierarchical cluster analyses distinguished three groups: Those who smoked primarily (81% of cigarettes) in the daytime (Early smokers; n = 15, 58% of total sample), those who smoked primarily (75% of cigarettes) at night (Late smokers; n = 7, 27%), and a distinct, classic "Social smoking" group (n = 4, 15% of total sample), who smoked mostly at night but also primarily when socializing or drinking (86% of their cigarettes), in the evening (71% of their cigarettes), on weekends (65% of their cigarettes), and in bouts (71% of their cigarettes). Overall, results suggest that non-daily smoking patterns are quite heterogeneous, and that many non-daily smokers may not be primarily social smokers.PhenX : Vector measures for tobacco regulatory research
AbstractRibisl, K. M., Chaloupka, F. J., Kirchner, T., Henriksen, L., Nettles, D. S., Geisler, R. C., Hendershot, T. P., & Swan, G. E. (n.d.).Publication year
2020Journal title
Tobacco controlVolume
29Issue
Suppl 1Page(s)
S27-S34AbstractThe PhenX (Phenotypes and eXposures) Toolkit provides researchers with recommended standard consensus measures for use in epidemiological, biomedical, clinical and translational studies. To expand the depth and breadth of measures in the PhenX Toolkit, the National Institutes of Health and U.S. Food and Drug Administration have launched a project to identify ' Core' and ' Specialty' collections of measures recommended for human subjects studies in tobacco regulatory research (TRR). The current paper addresses the PhenX Toolkit TRR Vector specialty area and describes the 6-month process to identify high-priority, low-burden, scientifically supported consensus measures. Self-reported, interviewer-administered and observational measurements were considered, and input from the research community assisted in justifying the inclusion of 13 tobacco industry-relevant measures (mainly interviewer-administered or self-reported measures) in the PhenX Toolkit. Compared with measures of addiction or the use of tobacco products, assessments of many Vector factors are much newer and at an earlier stage of development. More work is needed to refine and validate measures of the spatial distribution of tobacco retailers, retail environment, price promotions and corporate social responsibility.Predictors of residual invasive disease after core needle biopsy diagnosis of ductal carcinoma in situ
AbstractRutstein, L. A., Johnson, R. R., Poller, W. R., Dabbs, D., Groblewski, J., Rakitt, T., Tsung, A., Kirchner, T., Sumkin, J., Keenan, D., Soran, A., Ahrendt, G., & Falk, J. S. (n.d.).Publication year
2007Journal title
Breast JournalVolume
13Issue
3Page(s)
251-257AbstractCore needle biopsy (CNB) is used to sample both mammographically and ultrasound detected breast lesions. A diagnosis of ductal carcinoma in situ (DCIS) by CNB does not ensure the absence of invasive cancer upon surgical excision and as a result an upstaged patient may need to undergo additional surgery for axillary nodal evaluation. This study evaluates the accuracy of CNB in excluding invasive disease and the preoperative features that predict upstaging of DCIS to invasive breast cancer. Two hundred fifty-four patients over an 8-year period from 1994 to 2002 with a diagnosis of DCIS alone by CNB were retrospectively reviewed. Underestimation of invasive cancer by CNB was determined. Radiographic, pathologic, and surgical features of the cohort were compared using univariate and multivariate analysis. The mean age was 55 years (range 27-84) and mean follow-up was 25 months with one patient unavailable for follow-up. There were a total of six patient deaths, all of which were not disease-specific. A total of 21 out of 254 patients (8%) with DCIS by CNB were upstaged to invasive cancer following surgical excision. There was a significant inverse relationship between the number of core biopsies and the incidence of upstaging (p < 0.006) in that patients with fewer core samples were more likely to be upstaged at surgical pathology. No relationship was noted between the size of the core samples and the likelihood of upstaging (p > 0.4). Of 21 patients with invasion, all but two had comedonecrosis by CNB. Comedonecrosis by CNB significantly increased the likelihood of upstaging (p < 0.001). Of the 21 patients who were upstaged, 12 required subsequent surgery for nodal evaluation while nine had sentinel node biopsy at initial operation. Finally, upstaged patients were significantly more likely to have a positive margin (p < 0.008). Ductal carcinoma in situ with comedonecrosis on CNB can help to predict the possibility of invasion. Increasing the number of core biopsies reduced the likelihood of sampling error.Rapid grading of fundus photographs for diabetic retinopathy using crowdsourcing
AbstractBrady, C. J., Villanti, A. C., Pearson, J. L., Kirchner, T., Gupta, O. P., & Shah, C. P. (n.d.).Publication year
2014Journal title
Journal of medical Internet researchVolume
16Issue
10AbstractBackground: Screening for diabetic retinopathy is both effective and cost-effective, but rates of screening compliance remain suboptimal. As screening improves, new methods to deal with screening data may help reduce the human resource needs. Crowdsourcing has been used in many contexts to harness distributed human intelligence for the completion of small tasks including image categorization. Objective: Our goal was to develop and validate a novel method for fundus photograph grading. Methods: An interface for fundus photo classification was developed for the Amazon Mechanical Turk crowdsourcing platform. We posted 19 expert-graded images for grading by Turkers, with 10 repetitions per photo for an initial proof-of-concept (Phase I). Turkers were paid US $0.10 per image. In Phase II, one prototypical image from each of the four grading categories received 500 unique Turker interpretations. Fifty draws of 1-50 Turkers were then used to estimate the variance in accuracy derived from randomly drawn samples of increasing crowd size to determine the minimum number of Turkers needed to produce valid results. In Phase III, the interface was modified to attempt to improve Turker grading. Results: Across 230 grading instances in the normal versus abnormal arm of Phase I, 187 images (81.3%) were correctly classified by Turkers. Average time to grade each image was 25 seconds, including time to review training images. With the addition of grading categories, time to grade each image increased and percentage of images graded correctly decreased. In Phase II, area under the curve (AUC) of the receiver-operator characteristic (ROC) indicated that sensitivity and specificity were maximized after 7 graders for ratings of normal versus abnormal (AUC=0.98) but was significantly reduced (AUC=0.63) when Turkers were asked to specify the level of severity. With improvements to the interface in Phase III, correctly classified images by the mean Turker grade in four-category grading increased to a maximum of 52.6% (10/19 images) from 26.3% (5/19 images). Throughout all trials, 100% sensitivity for normal versus abnormal was maintained. Conclusions: With minimal training, the Amazon Mechanical Turk workforce can rapidly and correctly categorize fundus photos of diabetic patients as normal or abnormal, though further refinement of the methodology is needed to improve Turker ratings of the degree of retinopathy. Images were interpreted for a total cost of US $1.10 per eye. Crowdsourcing may offer a novel and inexpensive means to reduce the skilled grader burden and increase screening for diabetic retinopathy.Rapid surveillance of New York City healthcare center egress behaviors during the 2020 COVID-19 lockdown
AbstractKirchner, T., Jiang, H., Gao, H., Kabutaulaka, G., Cheong, D., Jiang, Y., Khan, A., Qiu, W., Tai, N., Truong, T., Virk, M., Gmelch, P. L., Carey, C., Laefer, D., & Laefer, D. (n.d.).Publication year
2023Journal title
Scientific DataVolume
10Issue
1AbstractThis rapid response surveillance project was funded by the National Science Foundation (NSF) to collect “perishable” data on egress behaviors and neighborhood conditions surrounding healthcare centers (HCCs) in New York City (NYC) during the initial NYC COVID-19 PAUSE ordinance from March 22nd to May 19th, 2020. Anonymized data on NYC HCC egress behaviors were collected by observational field workers using phone-based mapping applications. Each egress trip record includes the day of week, time of day, destination category type, along with an array of behavioral outcome categories, ambient weather conditions and socio-economic factors. Egress trajectories with precise estimates of distance traveled and the spatial dispersion or “spread” around each HCC were added via post-processing. The data collection and cleaning process resulted in 5,030 individual egress records from 18 facilities over a 9-week period.Reducing drinking among people experiencing homelessness : Protocol for the development and testing of a just-in-time adaptive intervention
AbstractBusinelle, M. S., Walters, S. T., Mun, E. Y., Kirchner, T., Hébert, E. T., & Li, X. (n.d.).Publication year
2020Journal title
JMIR Research ProtocolsVolume
9Issue
4AbstractBackground: Adults who are homeless are more likely to have alcohol use disorders (AUDs) compared with domiciled adults. Although AUD treatments are commonly available, many factors (eg, transportation limitations and inability to schedule appointments) contribute to low treatment completion rates and low success rates of these interventions among adults experiencing homelessness. Most adults who are homeless own mobile phones; however, no interventions have been developed that use mobile devices to deliver and support AUD interventions for this population. Mobile phone–based AUD interventions may reduce barriers that have limited the use and utility of traditional interventions. Objective: The aim of this study is to (1) identify variables (eg, affect, stress, geolocation, and cravings) that predict drinking among homeless adults (phase I), (2) develop a mobile intervention that utilizes an algorithm to identify moments of risk for drinking and deliver treatment messages that are tailored to the individual’s current needs in real time (phase II), and (3) pilot test the intervention app (phase III). Methods: In phase I, adults experiencing homelessness with an AUD (N=80) will complete baseline, equipment, 2-week, and 4-week follow-up visits in person. Participants will be prompted to complete five daily ecological momentary assessments on a study-provided smartphone for 28 days. The smartphone app will collect GPS coordinates every 5 min for the entire 28-day study period. Participants will wear a transdermal alcohol sensor that will objectively measure alcohol use. In phase II, we will use phase I data to develop an algorithm that identifies moments of heightened risk for drinking and develop treatment messages that address risk factors for drinking. Phase III will pilot test the intervention in 40 adults experiencing homelessness with AUD. Results: This project was funded in June 2018. IRB approval was obtained in October 2018, and data collection for phase I began in February 2019. Phase III data collection is expected to conclude in 2020. To date, 80 participants have consented to the study, and data analysis for phase I will begin in early 2020. Conclusions: This research will highlight intervention targets and develop a novel intervention for understudied and underserved adults experiencing homelessness with AUD.