David B Abrams

Professor of Social and Behavioral Sciences

Professional overview

Dr. David Abrams' career focuses on systems and social learning frameworks to inform population health enhancement. He has experience in testing theory, research design, measuring mechanisms of behavior change and outcome, and evaluating clinical trials (behavioral and pharmacological). His interests span topics from basic bio-behavioral mechanisms and clinical treatments to policy across risk factors and behaviors (e.g. tobacco/nicotine; alcohol, obesity, co-morbidity of medical and mental health), disease states (cancer; cardiovascular; HIV-AIDS), levels (biological, individual, organizational, worksite, community, global, and internet based), populations and disparities. His interests converge in the domain of implementation science to cost-efficiently inform evidence-based public health practice and policymaking.

Through transdisciplinary and translational research strategies, Dr. Abrams provides scientific leadership in tobacco control. His current focus is in strengthening global and United States tobacco and nicotine management strategies. Deaths of 1 billion smokers are estimated by 2100 caused overwhelmingly by use of combustible (smoked) tobacco products, not nicotine. Harm minimization is a key overarching systems strategy to speed the net public health benefit of emergent disruptive technologies for cleaner nicotine delivery. The goal is more rapid elimination of preventable deaths, disease burdens, and the widening gap in health disparities driven disproportionately by disparities in smoking.

Dr. Abrams was a professor and founding director of the Centers for Behavioral and Preventive Medicine at Brown University Medical School. He then directed the Office of Behavioral and Social Sciences Research at the National Institutes of Health (NIH). Until 2017, he was Professor of Health Behavior and Society at Johns Hopkins Bloomberg School of Public Health and the founding Executive Director of the Schroeder National Institute of Tobacco Research and Policy Studies at Truth Initiative (formerly the American Legacy Foundation).

Dr. Abrams has published over 250 peer reviewed scholarly articles and been a Principal Investigator on numerous NIH grants. He is lead author of The Tobacco Dependence Treatment Handbook: A Guide to Best Practices. He has served on expert panels at NIH and National Academies of Sciences, Engineering and Medicine on Obesity, Alcohol Misuse and Ending the Tobacco Problem: A Blueprint for the Nation. He has also served on the Board of Scientific Advisors of the National Cancer Institute (NIH-NCI) and was President of the Society of Behavioral Medicine.

For a complete list of Dr. Abrams' published work, click here.

Education

BSc (Hons), Psychology and Computer Science, University of the Witwatersrand, Johannesburg, South Africa

MS, Clinical Psychology, Rutgers University, New Brunswick, NJ

PhD, Clinical Psychology, Rutgers University, New Brunswick, NJ

Postdoctoral Fellow, Brown Medical School, Providence, RI

Honors and awards

Research Laureate Award, American Academy of Health Behavior (2014)

Joseph W. Cullen Memorial Award for Tobacco Research, American Society for Preventive Oncology (2008)

Distinguished Alumni Award: Rutgers University, The Graduate School, New Brunswick, NJ (2007)

The Musiker-Miranda Distinguished Service Award, American Psychological Association (2006)

Distinguished Service Award, Society of Behavioral Medicine (2006)

Outstanding Research Mentor Award, Society of Behavioral Medicine (2006)

Book of the Year Award: Tobacco Dependence Treatment Handbook. American Journal of Nursing (2005)

Distinguished Scientist Award, Society of Behavioral Medicine (1998)

Areas of research and study

Behavioral Science

Chronic Diseases

Evaluations

Implementation and Impact of Public Health Regulations

Implementation science

Population Health

Public Health Pedagogy

Public Health Systems

Research Design

Systems Integration

Systems Interventions

Tobacco Control

Translational science

Publications

Publications

Smoking among alcoholics during and after treatment: Implications for models, treatment strategies and policy

Monti, P., Rohsenow, D., Colby, S., & Abrams, D. (n.d.). In J. Fertig & J. Allen (Eds.), Alcohol and tobacco: From basic science to policy (1–).

Publication year

1995

The Working Well Trial: Baseline Dietary and Smoking Behaviors of Employees and Related Worksite Characteristics

Heimendinger, J., Feng, Z., Emmons, K., Stoddard, A., Kinne, S., Biener, L., Sorensen, G., Abrams, D., Varnes, J., & Boutwell, B. (n.d.).

Publication year

1995

Journal title

Preventive Medicine

Volume

24

Issue

2

Page(s)

180-193

10.1006/pmed.1995.1032

Abstract

Abstract

Background. The Working Well Trial, the largest randomized worksite health promotion trial to date, tests the effects of cancer prevention and control interventions on dietary and smoking behaviors of employees and the worksite environment. The trial is a 5-year cooperative agreement conducted in 57 matched pairs of worksites in 16 states by four study centers, a coordinating center, and the National Cancer Institute. The dual aims of this paper are to: (a) present a baseline description of the dietary and smoking habits of 20,801 employees, who are predominantly blue-collar workers; and (b) describe the social and physical environments of their worksites that may facilitate or hinder health behavior changes. Methods. The self-administered baseline survey of individuals consisted of a core set of questions common across all study centers on diet and smoking. The organizational survey consisted to eight instruments administered via interviews with key informants in each worksite. Continuous variables were analyzed by a mixed linear model and binary data were analyzed by the Generalized Estimating Equation. Results. The population represented is largely male (67.5%) and blue collar (53.5%). Mean levels of fat and fiber intakes were close to the national averages (36.6% of calories as fat and 13.1 g of fiber). Smoking prevalence (25.2%) was slightly lower than the national average. The worksites had a high level of health promotion activites (42% had nutrition programs, 53% had smoking control programs), but lacked environmental support for dietary behavior change and perceived support for smoking cessation. Conclusions. These findings replicate and extend previous research results to a large sample of diverse, largely blue-collar worksites. In addition the baseline results lay a foundation for the development of new insight into the relationship between individual and organizational level variables that may interact to influence behavioral and cultural norms.

An evaluation of the relationship between self-report and biochemical measures of environmental tobacco smoke exposure

Emmons, K. M., Abrams, D. B., Marshall, R., Marcus, B. H., Kane, M., Novotny, T. E., & Etzel, R. A. (n.d.).

Publication year

1994

Journal title

Preventive Medicine

Volume

23

Issue

1

Page(s)

35-39

10.1006/pmed.1994.1005

Abstract

Abstract

To evaluate the relationship between self-reported exposure to environmental tobacco smoke and saliva cotinine concentrations, we studied 186 nonsmokers. Each participant completed an exposure questionnaire, kept a daily exposure diary for 7 days, and provided a saliva sample for cotinine analysis. Salivary cotinine concentrations were measured using gas chromatography/mass spectrometry. of the volunteers, 30% lived with one or more smokers, and 84% were regularly exposed to smokers at work. Eighty-three percent of the volunteers had detectable saliva cotinine concentrations (≥0.5 ng/ml) (median = 1.1; range = 0.5-7.4 ng/ml). Cotinine concentrations were related to exposure in the household and at the workplace. Volunteers who lived with smokers had significantly higher cotinine levels (median = 1.0; range = <0.5-7.4 ng/ml) than those who did not (median = <0.5; range = <0.5-4.7 ng/ml). Volunteers who reported regular exposure at work had higher cotinine levels (median = 0.8; range = <0.5-7.4 ng/ml) than those who did not (median = <0.5; range = <0.5-3.0 ng/ml). Cotinine concentrations were predicted by a regression equation that included the number of smokers at home and work and the number of minutes of exposure recorded in the daily diary (r2 = 0.29).

Behavioral medicine for medical patients

Goldstein, M., Ruggiero, L., Guise, B., & Abrams, D. (n.d.). In A. Stoudemire & B. Vogel (Eds.), Clinical psychiatry for medical students (2nd eds., 1–).

Publication year

1994

Bridging research to action: A framework and decision-making process for cancer control

Fields, A., Best, A., Brisson, J., Engstrom, P., Holowaty, E., Wigle, D., Young, J., Kaegi, E., Beatty, D., Sondik, E., Vayda, E., Iverson, D., Sanson-Fisher, R., Abrams, D., Till, J., & Cameron, R. (n.d.).

Publication year

1994

Journal title

Canadian Medical Association Journal

Volume

151

Issue

8

Page(s)

1141-1146

Cancer control at the workplace: The working well trial

Abrams, D., Boutwell, W. B., Grizzle, J., Heimendinger, J., Sorensen, G., & Varnes, J. (n.d.).

Publication year

1994

Journal title

Preventive Medicine

Volume

23

Issue

1

Page(s)

15-27

10.1006/pmed.1994.1003

Abstract

Abstract

Background. Few research studies have been conducted on cancer prevention and control at the workplace. This article presents an overview of the largest worksite cancer control trial in the United States-The Working Well Trial-conducted in 114 worksites by four study centers, a coordinating center, and the National Cancer Institute. The trial′s organizational structure, research design, dependent measures, and theoretical model for intervention are described. Special features of the trial include using the worksite as the unit of randomization, intervention, and evaluation and a theory-driven conceptual model of intervention that places emphasis on individual and organizational targets for change, uses the transtheoretical stage of change model to guide a sustained 2-year multiple risk factor intervention, and makes use of volunteer resources within the worksite to reduce cost, increase participation, and improve tailoring to individual needs. The trial will have a potential impact on over 25,000 workers. Conclusion. The issues raised in this overview have implications for the evaluation and dissemination of cancer prevention and control programs to defined populations.

Challenges facing behavioral medicine in the 1990's: The development and maintenance of health promotion programs in the private teaching hospital.

Abrams, D., & Al., . (n.d.).

Publication year

1994

Journal title

The Behavior Therapist

Volume

15

Page(s)

198-201

Cue Reactivity as a Predictor of Drinking Among Male Alcoholics

Rohsenow, D. J., Monti, P. M., Rubonis, A. V., Sirota, A. D., Niaura, R. S., Colby, S. M., Wunschel, S. M., & Abrams, D. B. (n.d.).

Publication year

1994

Journal title

Journal of consulting and clinical psychology

Volume

62

Issue

3

Page(s)

620-626

10.1037/0022-006X.62.3.620

Abstract

Abstract

Social learning theories suggest that conditioned responses may increase the risk for relapse. Responses to alcohol use cues (cue reactivity) are associated with variables suggestive of risk but little research exists on the relationship of cue reactivity to treatment outcome. Alcoholic men admitted for detoxification to a treatment program (n = 45) underwent a cue reactivity assessment protocol, and 91% received 3-month follow-up interviews. Greater salivary reactivity predicted greater frequency of drinking during follow-up. Attentional factors added independent variance to the prediction of drinking outcome, with greater attention to stimulus or to response predicting less drinking. Cue reactivity did not predict length of hospital stay or latency to first drink. Results are discussed in the context of information processing, social learning theories, and clinical implications for relapse prevention.

Matching high-dependence and low-dependence smokers to self-help treatment with or without nicotine replacement

Niaura, R., Goldstein, M. G., & Abrams, D. B. (n.d.).

Publication year

1994

Journal title

Preventive Medicine

Volume

23

Issue

1

Page(s)

70-77

10.1006/pmed.1994.1010

Abstract

Abstract

Background. This study investigated the effect of matching smokers to nicotine replacement therapy (nicotine gum) on the basis of the pretreatment level of nicotine dependence. Methods. One hundred seventy-three smokers, classified as high or low on nicotine dependence using the Fagerstrom Tolerance Questionnaire, were assigned at random to receive nicotine gum (2 mg), chewed ad libitum, or to not receive nicotine gum. All smokers participated concurrently in a 5-week treatment program consisting of four brief counseling sessions combined with a self-help manual provided by the American Lung Association. Results. Results showed that smokers with high levels of nicotine dependence were significantly more likely to quit smoking during treatment if they received nicotine gum (31.9%) than high-dependence smokers who did not receive the gum (12.2%). There was a tendency for smokers with low levels of nicotine dependence to do worse during treatment if they received gum (13.5% quit) than they did when they received no gum (20% quit), although this difference was not statistically significant. The relative differences in outcomes persisted after 1 year of follow-up, but the high overall rate of relapse (92.5%) rendered the absolute size of the differences statistically insignificant. Conclusion. The results of the study are discussed in terms of strategies that might improve the success of treatment-matching approaches with newer forms of nicotine replacement therapies.

Mechanisms in Multiple Risk Factor Interventions: Smoking, Physical-Activity, and Dietary-Fat Intake Among Manufacturing Workers

Emmons, K. M., Marcus, B. H., Linnan, L., Rossi, J. S., & Abrams, D. B. (n.d.).

Publication year

1994

Journal title

Preventive Medicine

Volume

23

Issue

4

Page(s)

481-489

10.1006/pmed.1994.1066

Abstract

Abstract

Background. Individuals who have multiple poor health behaviors account for a disproportionately large percentage of the preventable U.S. health care cost burden. Understanding the relationships between multiple risk factors is important for the design of both individual and public health interventions. There have been few efforts to examine the cooccurrence of psychosocial and motivational mechanisms that mediate smoking, dietary fat intake, and physical activity in a defined population of blue collar workers. Methods. The sample comprised 1,559 manufacturing workers who participated in a self-help physical activity intervention and who completed a computerized assessment battery about their smoking, dietary fat intake, physical activity, and demographic characteristics. Results. Twenty-six percent of the sample were smokers, 51% did not exercise regularly, and 35% consumed more than an estimated 40% of calories per day from fat. Almost half of the sample was in the later stages of readiness for physical activity and dietary fat intake, compared with only 3% for smoking. Only 12% of the smokers had smoking as their only risk factor. Smokers were significantly more likely to engage in poor dietary and physical activity behaviors, compared with nonsmokers. The relationship among smoking status and the other risk factors was apparent both in terms of dietary fat and physical activity behaviors, as well as mediators such as motivation for change. Lower dietary fat intake was associated with an absence of the other two risk factors. Conclusions. The results suggest that there are important mediating mechanisms both within and among workers with one or more risk factors. Smokers are a particularly important target for health promotion interventions, and it may be possible to make initial contact with them through other health programs at the worksite. The role of other lifestyle changes as a gateway to smoking cessation has not yet been explored, but may have potential for reaching smokers who are very low in their motivational readiness to change. The implications of these findings for research and the design of multiple risk factor interventions are discussed.

Recruitment of work sites to a health promotion research trial implications for generalizability

Biener, L., DePue, J. D., Emmons, K. M., Linnan, L., & Abrams, D. B. (n.d.).

Publication year

1994

Journal title

Journal of Occupational Medicine

Volume

36

Issue

6

Page(s)

631-636

Abstract

Abstract

The characteristics of companies that either accepted or declined participation in a 5-year randomized trial of a multirisk factor health promotion intervention were compared to investigate potential limitations on the generalizability of research findings. A representative sample of 151 manufacturing work sites in the northeast was recruited to participate. Sixty-four of the companies were determined to be eligible and 10 others, which refused to have an administrator interviewed, were presumed to be eligible. Of this group, 27 companies agreed to participate. Workforce demographics, shift structure, and prior history of health promotion offerings were not significantly different in the two groups. However, participating companies employed fewer workers and had a more favorable financial outlook than did companies that declined to participate. Implications of these findings for research on work site health promotion are discussed.

Smoking at Home: The Impact of Smoking Cessation on Nonsmokers' Exposure to Environmental Tobacco Smoke

Emmons, K. M., Hammond, S. K., & Abrams, D. B. (n.d.).

Publication year

1994

Journal title

Health Psychology

Volume

13

Issue

6

Page(s)

516-520

10.1037/0278-6133.13.6.516

Abstract

Abstract

Nonsmokers who live with smokers are at increased risk for chronic disease. This study evaluated the impact of eliminating smoking in the home on nonsmokers' environmental tobacco smoke (ETS) exposure. Nonsmokers participated in measurements of their ETS exposure before and after the smoker in their home quit smoking. A matched comparison group of nonsmokers from nonsmoking homes was also included. ETS exposure was assessed using passive nicotine monitors, an exposure diary, and a questionnaire. Nonsmokers from smoking homes had significantly higher exposure to ETS than those from nonsmoking homes. There was a 60% reduction in nicotine levels following smoking cessation by the household smoker. However, there were still detectable levels of nicotine measured at posttest. These results have important implications for individual risk reduction and public health policy.

Smoking cessation at the workplace: Conceptual and practical issues

Abrams, D., Emmons, K., Linnan, L., & Biener, L. (n.d.). In R. Richmond (Ed.), Interventions for smokers: An international perspective (1–).

Publication year

1994

Taking an individualized approach to the assessment of self-efficacy and the prediction of alcoholic relapse

Miller, K. J., McCrady, B. S., Abrams, D. B., & Labouvie, E. W. (n.d.).

Publication year

1994

Journal title

Journal of Psychopathology and Behavioral Assessment

Volume

16

Issue

2

Page(s)

111-120

10.1007/BF02232722

Abstract

Abstract

The present study reports on a clinical instrument designed for assessing self-efficacy in alcoholics. In contrast to studies that construct general measures, it was proposed that taking an individualized approach to assessment might offer an effective methodology. Thirty-four alcoholics in an outpatient, behaviorally oriented treatment program participated as subjects. During therapy, an Individualized Self-Efficacy Survey (ISS) was developed for each subject. The ISS was developed by (a) administering the Drinking Patterns Questionnaire (DPQ) to identify important problem areas (e.g., work, children, marital) and specific drinking antecedents and (b) constructing a 15-item scale using each drinker's most important cues. The utility of having clients choose their own items was supported by finding a significant relationship between problem areas identified as important on the DPQ and the areas reported as surrounding relapse. ISS ratings were reflective of efficacy changes during treatment, while posttreatment ISS scores were predictive of subsequent relapse. Situation-specific prediction of relapse was not found. The advantages of this methodology for clinical use are discussed, while general directions for future research are suggested.

The effects of cue exposure on reaction time in male alcoholics

Sayette, M. A., Monti, P. M., Rohsenow, D. J., Gulliver, S. B., Colby, S. M., Sirota, A. D., Niaura, R., & Abrams, D. B. (n.d.).

Publication year

1994

Journal title

Journal of Studies on Alcohol

Volume

55

Issue

5

Page(s)

629-633

10.15288/jsa.1994.55.629

Abstract

Abstract

The present study investigates reaction time (RT) as a measure of attentional deficits produced during alcohol cue exposure. Twenty-four male alcoholic patients responded to a series of computer-generated tones as rapidly as possible during baseline and again during either an alcohol cue exposure period or exposure to a control beverage (water). Patients required increased time to respond to the tones when exposed to alcohol cues. No such increase in RT was found during exposure to a control beverage. In addition, RT was significantly correlated with self-reported urge to drink. These data provide initial validation for the use of RT as an objective measure of cue reactivity. Both theoretical and clinical implications for the use of RT as a measure of the effects of cue exposure are discussed.

Women and smoking cessation: Current status and future directions

Marcus, B., Emmons, K., Simkin, L., Albrecht, A., Stoney, C., & Abrams, D. (n.d.).

Publication year

1994

Journal title

Medicine, Exercise, Nutrition and Health

Volume

3

Page(s)

17-31

Alcohol cue reactivity: Effects of detoxification and extended exposure

Monti, P. M., Rohsenow, D. J., Rubonis, A. V., Niaura, R. S., Sirota, A. D., Colby, S. M., & Abrams, D. B. (n.d.).

Publication year

1993

Journal title

Journal of Studies on Alcohol

Volume

54

Issue

2

Page(s)

235-245

10.15288/jsa.1993.54.235

Abstract

Abstract

Alcoholics' reactions to drinking-related stimuli (cue reactivity) have been well documented and alcohol cue exposure treatment has been conducted recently in several clinical trials. Prior to conducting large-scale clinical trials it is important to know what effects detoxification may have on cue reactivity. However, no information is available about the effects of stage of detoxification or of detoxification medication on alcohol cue reactivity. In this study, 45 male alcoholics, detoxified without medication, were assessed during either their second, fourth or sixth day of withdrawal. Further, their reactivity was compared to that of alcoholics detoxified with chlordiazepoxide (n = 15), and to that of alcoholics in their fourth week after drinking (n = 28). Cue reactivity assessment investigated salivation and urge to drink after 3 minutes of water cue exposure and then after 3 minutes of alcohol cue exposure. Urges to drink were assessed during an additional 15 minutes of alcohol exposure to explore latency to maximum reactivity and habituation. Reactivity did not differ as a function of group membership, although salivation was elevated to both beverages during the first week of detoxification. Of the sample, 70% reacted to alcohol with increased urge and 65% with increased salivation, with no difference between groups in proportions of reactors. The maximum urge to drink occurred in the first 6 minutes of alcohol exposure, followed by a gradual and significant decrease. There were no differences on these measures between alcoholics in their first or fourth week after their last drink. Implications for theory and clinical applications are discussed.

Cue Exposure With Coping Skills Treatment for Male Alcoholics: A Preliminary Investigation

Monti, P. M., Rohsenow, D. J., Rubonis, A. V., Niaura, R. S., Sirota, A. D., Colby, S. M., Goddard, P., & Abrams, D. B. (n.d.).

Publication year

1993

Journal title

Journal of consulting and clinical psychology

Volume

61

Issue

6

Page(s)

1011-1019

10.1037/0022-006X.61.6.1011

Abstract

Abstract

Although early investigations were promising, no controlled follow-up studies have investigated the effectiveness of cue exposure treatment for alcoholics. In this study, inpatient alcoholics received either cue exposure integrated with urge coping skills training (CET, n = 22) or a contrast condition (CC) involving daily contact with assessment only (n = 18) in addition to standard treatment. Comprehensive assessment measures were used to investigate change in process and outcome variables. In the second 3 months after treatment, the CET group included more patients who were completely abstinent, had a higher percentage of abstinent days, and tended to report fewer drinks per day than did patients in the contrast condition. The significantly greater use of coping skills during follow-up by the CET group and the significant relationship of these coping skills to decreased drinking suggest that treatment effects were due, at least in part, to the coping skills training, consistent with recent formulations. Theoretical and treatment implications are discussed.

Development of a behavior analytically derived alcohol-specific role-play assessment instrument

Monti, P. M., Rohsenow, D. J., Abrams, D. B., Zwick, W. R., Binkoff, J. A., Munroe, S. M., Fingeret, A. L., Nirenberg, T. D., Liepman, M. R., Pedraza, M., Kadden, R. M., & Cooney, N. L. (n.d.).

Publication year

1993

Journal title

Journal of Studies on Alcohol

Volume

54

Issue

6

Page(s)

710-721

10.15288/jsa.1993.54.710

Abstract

Abstract

Social learning theory postulates that chronic alcohol abusers may have deficits in ability to cope with stressful situations, and these deficits may be associated with relapse after treatment. Attempts to study the hypothesized deficits have been hampered by methodological problems. Therefore, a behavior analytic procedure was used to develop 10 categories of situations based on over 600 drinking situations elicited from alcoholics. Role plays were developed for each of these categories, and samples of alcoholics in treatment were asked to respond as if they were trying not to drink. Videotaped responses were behaviorally rated by trained judges for skill and anxiety, and subjects completed self-report ratings of urge to drink, anxiety, difficulty and skill after each role play. Good interrater reliabilities and internal consistency were found across three samples of alcoholics, with virtually no gender differences. Previous and current investigations show the validity and utility of this instrument. The Alcohol Specific Role Play Test therefore shows promise as a means of assessing alcoholics' reactions to high-risk situations.

Smoking control at the workplace: current status and emerging issues.

Linnan, L. A., Emmons, K. M., Galuska, E. C., & Abrams, D. (n.d.).

Publication year

1993

Journal title

Rhode Island medicine

Volume

76

Issue

10

Page(s)

510-514

Treatment issues: Towards a stepped care model

Abrams, D., Orleans, C., Niaura, R., Goldstein, M., Velicer, W., & Prochaska, J. (n.d.).

Publication year

1993

Journal title

Tobacco Control

Volume

2

Page(s)

S17-S37

A cocaine high-risk situations questionnaire: Development and psychometric properties

Michalec, E., Zwick, W. R., Monti, P. M., Rohsenow, D. J., Varney, S., Niaura, R. S., & Abrams, D. B. (n.d.).

Publication year

1992

Journal title

Journal of substance abuse

Volume

4

Issue

4

Page(s)

377-391

10.1016/0899-3289(92)90044-X

Abstract

Abstract

Although high-risk situations have been identified for alcoholism, opiate abuse, and smoking, further research is needed to identify high-risk situations for cocaine abuse. A 233-item Cocaine High-Risk Situations Survey was developed based on a comprehensive literature review and was administered to 179 cocaine users in treatment. Situations that occurred infrequently or that were not often associated with cocaine use were eliminated and the remaining 89 items were factor analyzed using half the sample with confirmatory factor analysis on the remainder of the sample. Only one factor was found for frequency of cocaine use in these situations. The 21 items with high factor loadings and a diverse range of content were retained for subsequent analyses and renamed the Cocaine High-Risk Situations Questionnaire (CHRSQ). Reliability and convergent and discriminant validity of this scale were demonstrated. Frequency of alcohol use in the same situations was not significantly related to cocaine use and abuse, supporting discriminant validity. The findings suggest that the frequency of ongoing cocaine use is not determined by specific situations. Theoretical and clinical implications are discussed.

Assessing elements of women's decisions about mammography.

Rakowski, W., Dube, C. E., Marcus, B. H., Prochaska, J. O., Velicer, W. F., & Abrams, D. B. (n.d.).

Publication year

1992

Journal title

Health psychology : official journal of the Division of Health Psychology, American Psychological Association

Volume

11

Issue

2

Page(s)

111-118

10.1037/0278-6133.11.2.111

Abstract

Abstract

We investigated motivational and cognitive processes of behavior change with respect to mammography screening. One hundred forty-two women (ages 40 and older) recruited from three worksites answered a 41-item questionnaire consisting of statements based on constructs from the transtheoretical model of behavior change. Principal-components analysis identified two factors: a six-item component representing positive perceptions of mammography (Pros) and a six-item component representing avoidance of mammography (Cons). Analysis of variance showed that Pros, Cons, and a derived Decisional Balance measure (Pros minus Cons) were associated with stage of mammography adoption. Results are consistent with applications of the model to smoking cessation. The model is also discussed as it relates to other theories of behavior change and as a general strategy for analyzing perceptual data pertinent to health-related actions and intentions for behavioral change.

Assessment, classification, and treatment of obesity: A behavioral medicine perspective

Clark, M., Ruggiero, L., Pera, V., Goldstein, M., & Abrams, D. (n.d.). In A. Stoudemire & B. Vogel (Eds.), Principles of medical psychiatry (2nd eds., 1–).

Publication year

1992

Attendance and outcome in a work site weight control program: Processes and stages of change as process and predictor variables

Prochaska, J. O., Norcross, J. C., Fowler, J. L., Follick, M. J., & Abrams, D. B. (n.d.).

Publication year

1992

Journal title

Addictive Behaviors

Volume

17

Issue

1

Page(s)

35-45

10.1016/0306-4603(92)90051-V

Abstract

Abstract

This naturalistic study assessed client changes during treatment and identified salient predictors of therapy attendance and outcome. Subjects were assessed on processes and stages of change, self-efficacy, social support, weight history (including expectations, goals, and reasons for losing weight), and demographics at the beginning, middle, and end of a 10-week, behaviorally oriented work site program for weight control. Significant shifts from contemplation to action occured for clients remaining in treatment. There were also significant modifications in the use of change processes as a result of treatment: counterconditioning, contingency management, stimulus control, interpersonal control, and social liberation increased while medication use, wishful thinking, and minimizing threats decreased. Change processes employed during the early portion of the group treatment were the best predictors of treatment attendance and outcome, superior to self-efficacy, social support, weight history, and demographic variables. The results supported a transtheoretical model that emphasizes dynamic processes and stages as core dimensions for understanding how people change.