American foumal ofHealth Studies: 22(3) 2007 COMBINING TELEHEALTH AND E-LEARNING: A CASE STUDY IN SMOKING CESSATION PROGRAMMING Janice M. Putnam, R.N., Ph.D. Abstract: This study described the experience college students (age 18 to 24) had using a Web- based smoking cessation program. Data saturation was obtained through open-ended interviews (N=9). Data analysis used Colaizzi's technique and HyperRESEARCH© software. Primary themes identified were (1) helpful education; (2) using telehealth is an enabling experience; (3) mixed social and clinical support experiences; and (4) convenient and familiar format. Other themes involved smoking pattern changes and motivation to quit. The results of this study indicate that using an c-leaming delivery format for smoking cessation is an accessible health education and communication option for health education providers. T here is an overwhelming consensus that the high prevalence of tobacco use in college is a major health issue (Chalmers, Seguire & Brown, 2002; DeBernardo & Aldinger, 1999; Emmons, Abraham, Weschler, & Dowdall, 1998; Kelley, Thomas, & Freidmann, 2000; Martinelli, 1999; Rigotti, Regan & Moran, 2003; and Rigotti, Moran & Weschler, 2005). In the United States in 2005, there were 14.5 million students enrolled in 3,800 higher education institutions (National Center for Education Statistics, 2005). The use of tobacco reported by the college population (18- to 24-year-olcls) as reported by the National Survey on Drug Use and Health (2004) was 38.5%, higher than the national adult prevalence. According to Howe and Strauss (2003), mil- lennial generation college students (born between 1982 and 2002) are living in an environment where there is a plurality offece-to-faceand online inter- actions. Computers in college coursework are the norm. Telehealth is the delivery of interventions by healthcare providers on the Internet that may provide assistance in smoking cessation. EscofFery and colleagues (2005) report that out of 743 under- graduate students in two colleges, 53% would like to get their health information online, 74% report that they have received health information online, 40% have searched for health information online, and 28% report wanting to attend a health program online. Therefore, in meeting Responsibility VII - C and D ofthe Responsibilities and Competencies for Health Educators (2007), Internet communication may be a way to vary and foster health communica- tion with this population. The American Lung Association's Freedom from Smoking Program© is a "gold standard", and appears to be an effective intervention reporting an 85% quit attempt rate, a 29% 3 month point prevalence of abstinence, a 27% 6 month point prevalence, a 25% point prevalence at one year and a one year sustained abstinence of 19% (Lando, McGovern, Barros, & Etringer, 1990). However meetingfece-to-fecelimits the availability. Responsibility III .- A of the Responsibilities and Competencies for Health Educators (2007) speaks to exhibiting competency in planning educational programming. Providing Internet access to this "gold standard" was conceptualized to support flexible attendance. There were no studies identified in the literature review related to the efficacy of Freedom from Smoking© in an online program delivery format. At the present time, there is enormous popularity in technology as an alternative delivery format for smoking cessation (EscofFery, McCormick & Bateman, 2004; Feil, Noell, Litchenstein, Boles & McKay, 2003; Parlove, Cowdery, & Hoerauf, 2004; Stoddard, et al, 2005; Wang & Etter, 2004; ONeill, Gillespie & Slobin, 2000). Bock and associates (2004) performed a study assessing the content, quality and usability of smoking cessation treatment using an Internet delivery format. Ofthe 202 Internet sites identified, 23% offered treatment options and one in ten provided the interactivity that would classify it as telehealth. No information was provided on the effectiveness of these sites. The fanice M. Putnam R.N., Ph.D., currendy affiliated with University of Central Missouri. Address all correspondence to Janice M. Putnam, University of Central Missouri, Department of Nursing, University Healdi Center Room 102, Warrensburg, MO 64093; PHONE: (660) 543-8097; EMAIL: putnam@ucmo. edu. Work performed at University of Missouri - Kansas City and University of Central Missouri. -130-