evidence based practice self-change project

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  • 1. Self-Change Project: Smoking Less Josh Treppel, Nina Tracy, Erica Andersen and Ayelen Garcia

2. Self-Change Goal The goal of our Self-Change Project was to help Josh Treppel to smoke less by implementing a spiritual and behavioral intervention. 3. Chosen Interventions Spiritual Invention- Josh will recite a prayer asking God toremove his desire to smoke each time he is aboutto smoke a cigarette. Behavioral Intervention- Josh will keep a log documenting hiscigarette use.- Each time Josh smokes a cigarette, he willlog it. 4. Research Design ABAB research design 1. A- Measure Joshs current smoking rate (Cigarettes/day) to establish a baseline phase byJosh logging each time he has a cigarette. 2. B- Josh will begin the spiritual intervention. Hewill log each time he has a cigarette. 3. A- The spiritual intervention will cease, andJosh willcontinue to log his frequency of smoking. 4.B- The spiritual intervention will begin again,and Josh will continue to log his frequency ofsmoking. We chose this research design because it allows forreplication (increases validity), and also allows forcausality to be determined. 5. Measurement Josh measured his frequency of use through a self-report log. Each measurement was taken just after Josh smokeda cigarette. The baseline phase (A) lasted three days, and eachday Joshs frequency of use was measured. The spiritual intervention (B) lasted three days, andeach day Joshs frequency of use was measured. Withdrawal of the spiritual intervention (A) lastedthree days, and each day Joshs frequency of usewas measured. The spiritual intervention (B) was again implemented,lasting three days. Joshs frequency of use was 6. Data Points Each phase will have three data points - Each data point will represent a day andhow many cigarettes were smoked. There are twelve data points total (four phaseswith three data points in each phase). The data points will allow us to recognize trendsthrough the stability of the line. 7. Obtaining data and InformedConsent Before beginning our experiment, writteninformed consent was obtained. The study was explained to Josh, as was thecollection of data use and its publication forresearch purposes. Josh was given the option of confidentialityregarding the data used, but insisted that hisname be included in all research aspects in orderto possibly help others. 8. Pre- Intervention Interview Prior to beginning baseline procedures for smokinghabits, Josh was interviewed by the research team tocollect information pertaining to his job (jobdescription & scheduling), stress levels, the socialgroup he hangs out with, and his personal opinion onthe intervention and its effectiveness. This information was collected to identify possibleconfounding variables that may effect smoking habits,as well as to help shape our hypothesis. The interviewwill ensure that any results from the experiment werenot due to chance. Josh stated that he works at a dual diagnosistreatment facility with very unpredictable clients. Heworks 40 hours per week, including an 8 hour shift onSundays. He has Mondays and Tuesdays off of workand generally hangs around people who smoke 9. Our Hypotheses Hypothesis 1: The spiritual intervention willreduce Joshs cigarette intake during bothphases of the intervention. Hypothesis 2: Joshs cigarette intake will belower than baseline during the final phase ofthe intervention. 10. Data Results A- Baseline Phase (nointervention) Smoking Less 30- Day 1= 17 cigarettes- Day 2= 19 cigarettes 25 AB A B- Day 3= 22 cigarettes B- Spiritual Intervention 20- Day 4= 12 cigarettes # of Cigarettes- Day 5= 16 cigarettes 15- Day 6= 15 cigarettes A- Removal of intervention 10- Day 7= 24 cigarettes- Day 8= 22 cigarettes5- Day 9= 20 cigarettes B- Spiritual Intervention0- Day 10= 191 2 34 5 6 7 8 9 10 11 12- Day 11= 21 Days- Day 12= 18 11. Follow Up Interview There was a follow up interview with Josh threedays after the experiment ended. The research team asked Josh if he hadcontinued to utilize the spiritual intervention, evenafter the experiment had ended. Josh replied that he had been applying theintervention, and that it sometimes worked andsometimes didnt work. 12. Analyzing the Results The results of our experiment show that the spiritualintervention did reduce cigarette intake during both ofthe spiritual intervention phases (hypothesis 1).- Evidenced by Joshs cigarette intake decreasing by 5cigarettes during the first spiritual intervention phase (Joshhad an average of 19 cigarettes during days 1,2, &3 and an averageof 14 cigarettes during days 4,5, & 6).- Evidenced by Joshs cigarette intake decreasing by 3cigarettes during the second spiritual intervention phase(Josh had an average of 22 cigarette during days 7, 8, & 9 and anaverage of 19 cigarettes during days 10,11, & 12). The results of our experiment show that Joshscigarette intake returned to baseline during the finalphase of our experiment, instead of being lower thanbaseline (hypothesis 2).- Evidenced by the average number of cigarettes both being19 during days 1,2, & 3 and 10,11, & 12. 13. Discussion of the Results Josh believes that a certain level of reactivity mayhave contaminated the results of our experiment(lessening his cigarette intake to make the resultsmatch our hypothesis).- Evidenced by the decrease in cigarette intake during phase 2 ofour experiment ( days 4,5,&6). However, Josh believes that use of the spiritualintervention helped him lessen his cigaretteintake as well.- Evidenced by Joshs statement during the follow up interviewthat he still utilizes the spiritual intervention even after theexperiment ceased, and that the intervention sometimes works.- Reactivity effect can no longer be determined as an extraneousvariable because the experiment had already ended. 14. Discussion of the Results (cont.) Josh believes that his average cigarette intake did notdecrease during the final phase in comparison to thebaseline phase average due to his increased nicotine levelduring the third phase.- Evidenced by an average of 22 cigarettes in phase 3, and anaverage of 19 cigarettes in phase 4, which is the same as thebaseline. Josh believes that the increase in his cigarette intakeduring phase 3 may have been an indirect result of currentlife stressors that were occurring during that phase, as wellas a result of the cravings he was experiencing due to thedecrease in cigarette intake during phase 2.- Evidenced by Joshs statement during our follow up interviewthat the patients at his work were being rather difficult duringphase 3, and that his peers around him were also smoking moreheavily during this phase. 15. Future Research Recommendations In addition to recording cigarette intake eachday, we suggest that the participant also recordthe events of each day and how he/she is feeling. We recommend that all phases of the experimentbe recorded for no less than one week to helpaccount for all aspects of probability andextraneous variables. For example, each phaseof the intervention would last 7 days, instead of 3.