title: Formative evaluation of a practice-based smoking cessation program for diverse populations.
abstract: BACKGROUND
  Smoking rates are higher among those living at or below poverty and among persons with lower levels of education. We report on a formative research project examining patient perceptions of tobacco cessation strategies among diverse, low socioeconomic, urban smokers cared for in community-based primary care medical offices.
  
  
  METHODS
  We conducted 10 focus groups among low socioeconomic status participants recruited from urban primary care medical offices in Buffalo and Niagara Falls, New York. Participants included current or former smokers, who were stratified by age-group (18-39 years and 40+ years). The focus groups discussed perceptions of tobacco cessation strategies, previous quit attempts, and use/attitudes regarding technology and social media as potential platforms for cessation support.
  
  
  RESULTS
  Participants (n = 96) included predominantly African Americans (n = 62, 65%) and European Americans (n = 16, 16%); 56% were older than 40 years and 92% were low income. Most participants were supportive of cessation message delivery via phone; however, the age-groups varied in their attitudes on quitting smoking, desired frequency of phone contacts, and social media usage. Participants aged 18 to 39 years reported more Internet use, greater use of text messaging, and were more open to health information via social media.
  
  
  CONCLUSIONS
  Based on significant variation between younger and older smokers' perceptions of tobacco addiction and use of communication technologies, it appears reasonable to stratify the content and platform of health messaging by the target age-group.
authors.affiliation: 1Roswell Park Cancer Institute, Buffalo, NY, USA.
authors.forename: Martin C
authors.initials: MC
authors.lastname: Mahoney
authors.forename: Deborah O
authors.initials: DO
authors.lastname: Erwin
authors.forename: Christy
authors.initials: C
authors.lastname: Widman
authors.forename: Annamaria
authors.initials: A
authors.lastname: Masucci Twarozek
authors.forename: Frances G
authors.initials: FG
authors.lastname: Saad-Harfouche
authors.forename: Willie
authors.initials: W
authors.lastname: Underwood
authors.forename: Chester H
authors.initials: CH
authors.lastname: Fox
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D040421:Cell Phone / Q000706:statistics & numerical data; D054626:Consumer Health Information / Q000379:methods*; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009518:New York; D011203:Poverty; D011320:Primary Health Care / Q000379:methods / Q000458:organization & administration*; D036301:Qualitative Research; D016540:Smoking Cessation / Q000379:methods* / Q000706:statistics & numerical data; D061108:Social Media / Q000706:statistics & numerical data*; D014504:Urban Health; D055815:Young Adult
keywords: evaluation; focus groups; formative evaluation; health behavior; health promotion; media; qualitative methods; smoking and tobacco use; social media