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Challenges of Smoking Cessation Research in Mongolia Carol M University of Texas at Tyler Scholar Works at UT Tyler Nursing Theses and Dissertations School of Nursing Spring 5-6-2013 Challenges of Smoking Cessation Research in Mongolia Carol M. Rowley Follow this and additional works at: https://scholarworks.uttyler.edu/nursing_grad Part of the Nursing Commons Recommended Citation Rowley, Carol M., "Challenges of Smoking Cessation Research in Mongolia" (2013). Nursing Theses and Dissertations. Paper 15. http://hdl.handle.net/10950/109 This Dissertation is brought to you for free and open access by the School of Nursing at Scholar Works at UT Tyler. It has been accepted for inclusion in Nursing Theses and Dissertations by an authorized administrator of Scholar Works at UT Tyler. For more information, please contact [email protected]. Carol M. Rowley, R.N., Ph.D. CHALLENGES OF SMOKING CESSATION RESEARCH IN MONGOLIA by CAROL M. ROWLEY A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy Department of Nursing K. Lynn Wieck, Ph.D., Committee Chair College of Nursing and Health Sciences The University of Texas at Tyler May 2013 May 2013 © Copyright by Carol M. Rowley, 2013 All rights reserved Acknowledgements I would like to take the opportunity to express gratitude to a few of the many who have made completion of this effort possible. First, I would like to thank Jesus Immanuel, who has indeed never left me, failed me, or forsaken me through the long hours and years of my doctoral studies. I would also like to thank B. Oyunbileg (“Bilgee”), my translator, colleague, and friend. Bilgee cheerfully volunteered countless hours not only in translation but also in a variety of other services. It is likely that without her assistance this study would not have been feasible. Certainly, without my research assistants, A. Amarjargal, C. Baljinnyam, D. Baacanjargal, E. Gerelmaa, L. Khishigsuren, P. Mungunsukh, and T. Gantsetseg, this research would have been impossible. I am grateful for the hours they invested in training as well as in counseling study participants. I also realize that without the administration and nursing faculty of the University of Texas at Tyler creating their online PhD in Nursing program, this research would have never even begun. In particular, I would like to thank my adviser, Dr. K. Lynn Wieck, for her helpful guidance and encouragement to me throughout the program as well as during this research project. She and the remainder of my dissertation committee (Elaine Ballard, D.N.P., Peggy Landrum, Ph.D., and Susan Yarbrough, Ph.D.) have been a great support to me through this process. Finally, I would also like to express gratitude to the Mary Coulter Dowdy Distinguished Nursing Professorship for funding costs of cotinine testing supplies for this study. Table of Contents List of Tables ............................................................................................................vi List of Figures ...........................................................................................................vii Abstract .....................................................................................................................viii Chapter 1. Overview of the Research Overall Purpose of the Study .........................................................................1 Introduction of Articles ..................................................................................2 References ......................................................................................................5 Chapter 2. Smoking Habits and Influences in Eastern Europe, the former Soviet Union, and Mongolia Abstract ..........................................................................................................7 Manuscript .....................................................................................................8 Electronic Search Methods ............................................................................9 Smoking Habits and Influences .....................................................................10 Age and Gender Prevalence Rates and Trends ..................................11 Social Groups and Relationships .......................................................15 Education and Socioeconomic Status ................................................16 Mental Health and Beliefs .................................................................18 Tobacco Marketing and Control ....................................................................21 Cessation and Intervention Studies ................................................................24 Analysis..........................................................................................................26 i Conclusion .....................................................................................................31 References ......................................................................................................32 Chapter 3. Evaluation of a Motivational Coaching Intervention to Impact Smoking Habits of Male Mongolian University Students Abstract ..........................................................................................................40 Manuscript .....................................................................................................41 Significance Statement...................................................................................41 Purpose of the Research Study ......................................................................42 Theoretical Framework ..................................................................................42 Conceptual and Operational Definition of the Variables ...................44 Smoking cessation autonomous self-regulation.......................44 Smoking frequency. .................................................................45 Smoking intensity. ...................................................................45 Motivational counseling intervention. .....................................45 Review of the Literature ................................................................................45 Research Design and Methods .......................................................................49 Hypotheses .........................................................................................49 Human Subjects Protection ................................................................49 Sample................................................................................................50 Instruments .........................................................................................51 Translation. ..............................................................................51 Smoking cessation autonomous self-regulation.......................52 Questionnaires on smoking habits. ..........................................54 ii Demographic data. ...................................................................55 Procedures ..........................................................................................56 Research assistant training. ......................................................56 Recruitment. .............................................................................57 Intervention and data collection. ..............................................58 Results ............................................................................................................59 Statistical Analysis .............................................................................59 Sample................................................................................................60 Smoking Cessation Autonomous Self-Regulation.............................60 Smoking Frequency ...........................................................................61 Smoking Intensity ..............................................................................61 Hours Between Smokes .....................................................................62 Self-Ranked Cessation Importance, Ability, and Readiness .............62 Experienced Challenges with Cessation ............................................63 Smoking Cessation.............................................................................63 Research Assistant Interviews ...........................................................63 Strengths and Limitations ..............................................................................67 Discussion and Recommendations ................................................................68 References ......................................................................................................74 Chapter 4. Summary and Conclusion Overview of Findings ....................................................................................82 Recommendations Based on Findings ...........................................................84 References ......................................................................................................86 iii Appendices Appendix A: Smoking Cessation Intervention Model .................................87 Appendix B: Treatment Self-Regulation Questionnaire for Smoking ..........88 Appendix C: Questionnaire on Smoking Habits ............................................89 Appendix D: Ulaanbaatar University Approval ............................................91 Appendix E: UTT IRB Approval ...................................................................92 Appendix F: UTT IRB Approval
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