Analysis of a multicomponent smoking cessation project: what worked and why.
BACKGROUND
Health promotion interventions often contain several, conceptually diverse elements. As a result, it is often difficult to determine why interventions succeed or fail as well as which components should be retained or eliminated. One method to examine the effectiveness of individual intervention elements is process analysis.


METHODS
Kick It! is a multicomponent smoking cessation intervention developed for lower socioeconomic African Americans. The intervention includes several components, including a 24-page printed cessation manual, a staged-cessation video, a quit contract, two "Quit and Win" contests, and a single telephone booster call. Using data from a randomized intervention trial designed to test the efficacy of the Kick It! intervention, this article examines the use, impact, and interaction of the intervention's subcomponents as well as possible mediating variables related to successful quitting among intervention participants (n = 650).


RESULTS
In univariate as well as multivariate analyses adjusting for age and stage of change, two of the five elements, watching the video and entering a Quit and Win contest, were significantly associated with 6-month point prevalence abstinence. Submitting a quit contract and receiving the booster call were significantly associated with quitting in univariate analyses, while reading the Kick It! guide was not significantly associated with quitting in either analysis.


CONCLUSIONS
Despite the positive effects observed for individual elements, quitting was not significantly greater among intervention relative to comparison subjects. The primary reason for this appears to be the overall lack of intervention use. Additional research examining strategies to increase use of the Kick It! intervention components as well as the optimal sequencing and combination of components may be warranted.
Resnicow
K
K
Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, USA.
Royce
J
J
Vaughan
R
R
Orlandi
M A
MA
Smith
M
M
D000328:Adult; D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data; D003163:Competitive Behavior; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006266:Health Education / Q000379:methods; D006293:Health Promotion / Q000379:methods / Q000592:standards*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010043:Outcome and Process Assessment, Health Care; D010349:Patient Compliance; D015397:Program Evaluation; D016540:Smoking Cessation / Q000379:methods* / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014743:Videotape Recording