Assessing the Testability of the Multi-Theory Model (MTM) in Predicting Vaping Quitting Behavior among Young Adults in the United States: A Cross-Sectional Survey
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Participants
2.2. Data Collection and Sampling
2.3. Ethical Considerations
2.4. Survey Instrument
2.5. Face and Content Validity of the Survey Instrument
2.6. Sample Justification
2.7. Data Analysis
3. Results
3.1. Structural Model Assessment
3.1.1. Initiation
3.1.2. Sustenance
3.2. Reliability Diagnostics
3.3. Demographic and Behavioral Characteristics
3.4. Mean Values of MTM Constructs
3.5. Intercorrelation Matrix
3.6. Hierarchical Multiple Regression
4. Discussion
4.1. Implications for Practice
4.2. Strengths and Limitations of the Study
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Demographic Characteristic | Census Distribution, Population Parameters (%) |
---|---|
Gender | Male: 48%; Female: 52%; Non-binary: natural fallout |
Race | White (~75%); Black/AA (~13%); Asian or Pacific Islander (~6%); American Indian/Alaskan Native/Other (~6%) |
Ethnicity | Hispanic (~18%); Non-Hispanic (~82%) |
Region | Northeast: 17%; Midwest: 21%; West: 24%; South: 38% |
Variable | Categories | Descriptive Statistic | 95% CI (LCL, UCL) |
---|---|---|---|
Gender | Female | 322 (52.0) | 48.0, 56.0 |
Male | 289 (46.7) | 42.7, 50.7 | |
Other | 8 (1.3) | 0.6, 2.5 | |
Age in years (M ± SD) | - | 21.74 ± 1.6 | 21.61, 21.87 |
Race | American Indian or Alaska Native | 10 (1.7) | 0.8, 3.0 |
Asian | 36 (6.0) | 4.2, 8.1 | |
Black or African American | 81 (13.4) | 10.8, 16.4 | |
White | 463 (76.5) | 72.9, 79.9 | |
Others including the multiethnic origin | 15 (2.5) | 1.4, 4.1 | |
Ethnicity | Hispanic | 111 (17.9) | 15.0, 21.2 |
Non–Hispanic | 508 (82.1) | 78.8, 85.0 | |
Region | Midwest | 132 (21.3) | 18.2, 24.8 |
Northeast | 107 (17.3) | 14.4, 20.5 | |
South | 238 (38.4) | 34.6, 42.4 | |
West | 142 (22.9) | 19.7, 26.5 | |
Education | College Degree (Associate or Bachelors) | 133 (21.4) | 18.3, 24.9 |
Graduate Degree | 27 (4.4) | 2.9, 6.3 | |
High school graduate (or equivalent including GED) | 229 (37.0) | 33.2, 40.9 | |
Some college but no degree | 201 (32.5) | 28.8, 36.3 | |
Other | 29 (4.7) | 3.2, 6.7 | |
Employed | Yes | 402 (64.9) | 61.0, 68.7 |
No | 217 (35.1) | 31.3, 39.0 | |
* Hours worked (Per week) (M ± SD) | - | 32.41 ± 11.5 | 31.18, 33.64 |
Income | Less than $ 50,000 | 315 (50.9) | 46.9, 54.9 |
$ 50,000 to $ 100,000 | 225 (36.3) | 32.6, 40.3 | |
$100,001 to $150,000 | 52 (8.4) | 6.3, 10.9 | |
$150,001 to $200,000 | 18 (2.9) | 1.7, 4.6 | |
More than $200,000 | 9 (1.5) | 0.7, 2.7 |
Variable | Categories | Frequencies (Percentages) | 95% CI (LCL, UCL) |
---|---|---|---|
Vape Type | Cannabis | 206 (33.3) | 29.6, 37.1 |
Nicotine | 384 (62.0) | 58.1, 65.9 | |
Other | 29 (4.7) | 3.2, 6.7 | |
Do you smoke cigarettes | Yes | 276 (44.6) | 40.6, 48.6 |
No | 343 (55.4) | 51.4, 59.4 | |
Do you drink alcohol | Yes | 510 (82.4) | 79.2, 85.2 |
No | 109 (17.6) | 14.8, 20.8 | |
How many of your closest friends vape | One or more | 570 (92.1) | 89.7, 94.1 |
None | 49 (7.9) | 5.9, 10.3 | |
Family members who vape | Yes | 326 (52.7) | 48.6, 56.7 |
No | 293 (47.3) | 43.3, 51.4 | |
Suffered from any mental health outcome as a result of vaping | Yes | 221 (35.8) | 32.0, 39.7 |
No | 397 (64.2) | 60.3, 68.0 | |
Suffered from any physical health outcome as a result of vaping | Yes | 265 (42.8) | 38.9, 46.8 |
No | 354 (57.2) | 53.2, 61.1 |
Variables | Possible range (Min, Max) | Range (Min, Max) | Mean ± SD | Skewness | Kurtosis |
---|---|---|---|---|---|
Intent of Initiation | (0, 4) | (0, 4) | 1.89 ± 1.32 | 0.112 | −1.058 |
1. Perceived advantages | (0, 20) | (0, 20) | 11.43 ± 4.83 | −0.089 | −0.702 |
2. Perceived disadvantages | (0, 20) | (0, 20) | 7.50 ± 4.52 | 0.239 | −0.556 |
3. Behavioral Confidence | (0, 20) | (0, 20) | 8.84 ± 6.02 | 0.176 | −0.835 |
4. Changes in the Physical Environment | (0, 20) | (0, 20) | 10.09 ± 5.56 | 0.045 | −0.668 |
Intent of Sustenance | (0, 4) | (0, 4) | 1.74 ± 1.35 | 0.184 | −1.086 |
5. Emotional Transformation | (0, 12) | (0, 12) | 5.98 ± 3.55 | 0.043 | −0.726 |
6. Practice for Change | (0, 12) | (0, 12) | 5.77 ± 3.43 | 0.088 | −0.715 |
7. Changes in the Social Environment | (0, 12) | (0, 12) | 6.05 ± 3.40 | −0.046 | −0.637 |
Variables | 1 | 2 | 3 | 4 | 5 | 6 |
---|---|---|---|---|---|---|
1. Participatory Dialogue | 1 | 0.25 ** | 0.29 ** | 0.32 ** | 0.27 ** | 0.25 ** |
2. Behavioral Confidence | 0.25 ** | 1 | 0.77 ** | 0.74 ** | 0.72 ** | 0.50 ** |
3. Changes in the Physical Environment | 0.29 ** | 0.77 ** | 1 | 0.80 ** | 0.76 ** | 0.59 ** |
4. Emotional Transformation | 0.32 ** | 0.74 ** | 0.80 ** | 1 | 0.79 ** | 0.55 ** |
5. Practice for Change | 0.27 ** | 0.72 ** | 0.76 ** | 0.79 ** | 1 | 0.60 ** |
6. Changes in the Social Environment | 0.25 ** | 0.50 ** | 0.59 ** | 0.55 ** | 0.60 ** | 1 |
Variables | Model 1 | Model 2 | Model 3 | Model 4 | ||||
---|---|---|---|---|---|---|---|---|
B | β | B | β | B | β | B | β | |
Constant | 3.241 ** | - | 2.542 * | - | 1.275 | - | 0.888 | - |
Age | −0.023 | −0.028 | −0.019 | −0.024 | −0.017 | −0.020 | −0.012 | −0.014 |
Gender: Male (Ref: Female) | 0.096 | 0.036 | 0.071 | 0.027 | 0.055 | 0.021 | 0.013 | 0.005 |
Other gender (Ref: Female) | −0.996 * | −0.085 | −0.740 | −0.063 | −0.695 | −0.059 | −0.630 | −0.054 |
Race: Non-White (Ref: White) | 0.103 | 0.034 | 0.143 | 0.047 | −0.018 | −0.006 | 0.008 | 0.003 |
Ethnicity: Non-Hispanic (Ref: Hispanic) | −0.280 | −0.081 | −0.141 | −0.041 | −0.062 | −0.018 | −0.042 | −0.012 |
Region: Northeast (Ref: Midwest) | 0.059 | 0.017 | 0.062 | 0.018 | 0.051 | 0.015 | 0.052 | 0.015 |
South | 0.177 | 0.065 | 0.134 | 0.049 | 0.165 | 0.061 | 0.196 | 0.072 |
West | 0.060 | 0.019 | 0.071 | 0.023 | 0.145 | 0.046 | 0.156 | 0.049 |
Education (Ref: Associate or Bachelors) | ||||||||
Graduate Degree | 0.166 | 0.026 | 0.177 | 0.027 | 0.078 | 0.012 | 0.133 | 0.021 |
High school graduate or equivalent | −0.127 | −0.046 | −0.044 | −0.016 | −0.019 | −0.007 | −0.057 | −0.021 |
Some college but no degree | −0.164 | −0.058 | −0.099 | −0.035 | −0.129 | −0.046 | −0.202 | −0.072 |
Other | 0.085 | 0.014 | 0.209 | 0.033 | 0.041 | 0.007 | −0.014 | −0.002 |
Income: $ 50,000 to $ 100,000 (Ref: <$50,000) | −0.017 | −0.006 | −0.022 | −0.008 | 0.003 | 0.001 | −0.017 | −0.006 |
$100,001 to $150,000 | 0.102 | 0.021 | 0.129 | 0.027 | −0.036 | −0.007 | −0.023 | −0.005 |
$150,001 to $200,000 | 0.060 | 0.008 | 0.128 | 0.016 | −0.262 | −0.033 | −0.347 | −0.044 |
More than $200,000 | −0.020 | −0.002 | −0.168 | −0.015 | −0.399 | −0.036 | −0.392 | −0.035 |
Cigarette smoking (Ref: No) | −0.099 | −0.037 | −0.020 | −0.008 | 0.088 | 0.033 | 0.087 | 0.033 |
Alcohol consumption (Ref: No) | −0.20 | −0.058 | −0.182 | −0.052 | −0.247 * | −0.071 | −0.214 | −0.062 |
Vaping among friends (Ref: No) | −0.417 * | −0.085 | −0.30 | −0.061 | −0.097 | −0.020 | −0.089 | −0.018 |
Vaping among family (Ref: No) | −0.195 | −0.074 | −0.083 | −0.032 | −0.013 | −0.005 | 0.018 | 0.007 |
Participatory dialogue | - | - | 0.064 ** | 0.290 | 0.036 ** | 0.163 | 0.03 ** | 0.136 |
Behavioral confidence | - | - | - | - | 0.123 ** | 0.560 | 0.076 ** | 0.345 |
Changes in the physical environment | - | - | - | - | - | - | 0.069 ** | 0.291 |
R2 | 0.050 | - | 0.127 | - | 0.406 | - | 0.439 | - |
F | 1.568 | - | 4.120 ** | - | 18.514 ** | - | 20.215 ** | - |
Δ R2 | 0.050 | - | 0.077 | - | 0.279 | - | 0.033 | - |
Δ F | 1.568 | - | 52.455 ** | - | 280.310 ** | - | 34.646 ** | - |
Variables | Model 1 | Model 2 | Model 3 | Model 4 | ||||
---|---|---|---|---|---|---|---|---|
B | β | B | β | B | β | B | β | |
Constant | 2.113 * | - | 0.878 | - | 0.339 | - | 0.029 | - |
Age | 4 | 0.011 | 0.007 | 0.008 | 0.013 | 0.015 | 0.018 | 0.022 |
Gender: Male (Ref: Female) | 0.12 | 0.045 | 0.103 | 0.038 | 0.095 | 0.035 | 0.1 | 0.037 |
Other gender (Ref: Female) | −0.516 | −0.043 | −0.121 | −0.01 | −0.083 | −0.007 | −0.236 | −0.02 |
Race: Non-White (Ref: White) | 0.112 | 0.036 | 0.017 | 0.005 | −0.043 | −0.014 | −0.03 | −0.01 |
Ethnicity: Non-Hispanic (Ref: Hispanic) | −0.331 * | −0.094 | −0.228 | −0.065 | −0.197 | −0.056 | −0.163 | −0.046 |
Region: Northeast (Ref: Midwest) | 0.175 | 0.049 | 0.179 | 0.05 | 0.22 | 0.062 | 0.182 | 0.051 |
South | 0.273 | 0.098 | 0.229 | 0.083 | 0.237 | 0.085 | 0.225 | 0.081 |
West | 0.225 | 0.07 | 0.229 | 0.071 | 0.261 | 0.081 | 0.228 | 0.071 |
Education (Ref: Associate or Bachelor’s) | ||||||||
Graduate Degree | 0.135 | 0.02 | −0.085 | −0.013 | −0.006 | −0.001 | 0.063 | 0.009 |
High school graduate or equivalent | −0.155 | −0.056 | −0.224 | −0.08 | −0.149 | −0.053 | −0.116 | −0.042 |
Some college but no degree | −0.331 * | −0.115 | −0.376 * | −0.131 | −0.269 * | −0.094 | −0.29 * | −0.101 |
Other | −0.069 | −0.011 | −0.181 | −0.028 | −0.091 | −0.014 | −0.085 | −0.013 |
Income: $ 50,000 to $ 100,000 (Ref: <$50,000) | 0.031 | 0.011 | 0.033 | 0.012 | 0.015 | 0.005 | 0.011 | 0.004 |
$100,001 to $150,000 | 0.039 | 0.008 | −0.034 | −0.007 | −0.055 | −0.011 | −0.02 | −0.004 |
$150,001 to $200,000 | −0.112 | −0.014 | −0.345 | −0.043 | −0.443 | −0.055 | −0.44 | −0.055 |
More than $200,000 | −0.065 | −0.006 | −0.245 | −0.022 | −0.126 | −0.011 | −0.212 | −0.019 |
Cigarette smoking (Ref: No) | −0.163 | −0.06 | −0.091 | −0.034 | −0.116 | −0.043 | −0.1 | −0.037 |
Alcohol consumption (Ref: No) | 0.001 | 0.003 | 0.02 | 0.006 | 0.073 | 0.021 | 0.056 | 0.016 |
Vaping among friends (Ref: No) | −0.309 | −0.062 | −0.266 | −0.053 | −0.187 | −0.037 | −0.218 | −0.044 |
Vaping among family (Ref: No) | −0.114 | −0.042 | 0.017 | 0.006 | 0.026 | 0.01 | 0.048 | 0.018 |
Emotional transformation | - | - | 0.195 ** | 0.512 | 0.069 * | 0.181 | 0.054 * | 0.141 |
Practice for change | - | - | - | 0.167 ** | 0.425 | 0.131 ** | 0.332 | |
Changes in the social environment | - | - | - | - | 0.082 ** | 0.206 | ||
R2 | 0.045 | - | 0.298 | - | 0.364 | - | 0.390 | - |
F | 1.416 | - | 12.082 ** | - | 15.531 ** | - | 16.533 ** | - |
Δ R2 | 0.045 | - | 0.253 | - | 0.066 | - | 0.026 | - |
Δ F | 1.416 | - | 215.257 ** | - | 62.013 ** | - | 24.889 ** | - |
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Sharma, M.; Batra, K.; Batra, R.; Dai, C.-L.; Hayes, T.; Ickes, M.J.; Singh, T.P. Assessing the Testability of the Multi-Theory Model (MTM) in Predicting Vaping Quitting Behavior among Young Adults in the United States: A Cross-Sectional Survey. Int. J. Environ. Res. Public Health 2022, 19, 12139. https://doi.org/10.3390/ijerph191912139
Sharma M, Batra K, Batra R, Dai C-L, Hayes T, Ickes MJ, Singh TP. Assessing the Testability of the Multi-Theory Model (MTM) in Predicting Vaping Quitting Behavior among Young Adults in the United States: A Cross-Sectional Survey. International Journal of Environmental Research and Public Health. 2022; 19(19):12139. https://doi.org/10.3390/ijerph191912139
Chicago/Turabian StyleSharma, Manoj, Kavita Batra, Ravi Batra, Chia-Liang Dai, Traci Hayes, Melinda J. Ickes, and Tejinder Pal Singh. 2022. "Assessing the Testability of the Multi-Theory Model (MTM) in Predicting Vaping Quitting Behavior among Young Adults in the United States: A Cross-Sectional Survey" International Journal of Environmental Research and Public Health 19, no. 19: 12139. https://doi.org/10.3390/ijerph191912139