All posts tagged "X-Files"
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Science / Tech
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THE KONG SHOW: MARCH MADNESS
Director: Powell Leonard, Powella Productions' LionHearted Players
Monday, March 23: The LionHearted Players Present: "The Kong Show"
The Biggest Little Vaudeville-Style Variety Show in Times Square
Join Powella Productions and the LionHearted Players as they present their latest comedy variety show "The Kong Show: March Madness" on Monday, March 23rd at 7pm, right in the heart of Times Square, at the Sage Theater, located at 711 7th Avenue (between 47th & 48th Street). Join Powell Leonard (as "Chuck E. Baby") and Miss Ella and as they host "The Kong Show: March Madness" for an evening of big-time laughs with the lion kings of sketch-comedy the LionHearted Players featuring Andrew Cordle and Cathy Schramm; the sketch comedy antics of the critically acclaimed Punch59; the amazing close-up magic of magician Dave Cremin; and special guests comedian Ben Lerman and comedienne Margot Leitman; for a night of big-time entertainment that would make the great ape, King Kong, himself proud. "The Kong Show" is vaudeville for the 21st Century live on stage. It's more than just sketch, it's more than just stand up, it's more than you can imagine!
Arrive early at 6:30pm for an after-work special. Treat yourself to a drink in the Sage Theater lounge and enjoy a pre-show mini-concert by the international award-winning soloist, Andrew Cordle.
Tickets: $15 at door day of the show/ $12 in advance. Call Powella Productions: 718-482-8790
Advance Tickets available on-line at: http://thekongshowmarchmadness.eventbrite.com
Directions: SUBWAY: N/R to 49th St., 1/9 to 50th St., F/V or B/D to 47th-50th St.
"Suffering from a case of the Mondays? Laugh your blues away at the Sage Theater featuring a slew of hip vaudeville and variety acts sure to keep you in stitches. Don't miss the LionHearted Players best known for their sold-out variety spoof "American Midol," (now presenting Powell Leonard as Chuck E. Baby in "The Kong Show") . . . as well as the sketch comic troupe PUNCH 59 and Magician Dave Cremin."
~ Daily News
THE LIONHEARTED PLAYERS is a Queens-based comedy troupe that began as an actor's workshop in the Lower East Side's Planet One Café in 2001. Since then, producers (and spouses) Powell Leonard and Miss Ella have produced variety, music, and comedy shows featuring some of New York's most talented singers and comedians. Powella Productions' The LionHearted Players have performed to packed houses all over New York City including Don't Tell Mama's, Danny's Skylight, the Broadway Comedy Club, and the Undercroft Performance Space.
ANDREW CORDLE has appeared throughout the United States, Canada, Europe and South America as a soloist, chamber musician and orchestral performer. He has won many prizes and awards internationally, for which he has received the highest critical acclaim. After an absence of many seasons from the stage as an actor, Mr. Cordle performed with STAR, the Senior Theatre Acting Repertory in 2008 as Willie in Neil Simon's "The Sunshine Boys." He is the LionHearted Player's newest member being featured as both a musician and actor.
CATHY SCHRAMM is appearing once again with the LionHearted Players. In her debut performance she was a pill popping, hard drinking, chain smoking, cheerleader mom. And now, she has once again been type cast, this time she is appearing as the mischievous, the insane, Alice Osborne a.k.a. the Devil!
MAGICIAN DAVE CREMIN puts a twisted spin on old tricks, combining stand-up with magic, illusion, and sleight of hand. You may want to leave the kids - and your larger bills - at home. This ain't your kids' birthday party magic show! Dave Cremin has performed professionally in the magic arena for more than 15 years. Skilled with a diverse array of presentations, his magic is suitable, not only for private parties and weddings, but also trade shows and sales seminars, and pretty much anything else in between. Dave's recipe is simple--combine magic and comedy, add a generous helping of charm and personality, give it a good stir, and you've got an act that's sure to please. Past performances include, Don't Tell Mama, The Broadway Comedy Club, The Sage Theatre, and PA TV along with several independent film productions. Dave's love for magic dates back to his teen years but, only when he came to New York in the mid eighties, did he realize that he had an aptitude and a passion for performing the art. Always striving for perfection, Dave polishes new material several nights a week as a Magical Bartender at Cronin and Phelan's Bar & Restaurant in Astoria, Queens. www.outofthisworldmagic.com
PUNCH 59 Sketch Comedy has performed at the Broadway Comedy Club, Under St. Marks, Gene Frankel Underground, Laugh Factory, and of course, at the Sage with the "KONG SHOW". They take pride in staging irreverent, intelligent sketch comedy in the grand tradition of those who came before (SNL, Kids In The Hall). PUNCH 59 (along with Jen Ryan and Rik Sansone as the Rev. Bill and Betty Holland) are always performing live in NYC and posting original sketches on their website --- visit punch59comedy.com for upcoming show dates and more!
BEN LERMAN is a NYC singer-songwriter and comedian making his TV debut in March on HereTV. Ben has toured nationally, is a regular guest on the Frank DeCaro Show on Sirius Radio, and hosts a monthly live version of the Match Game at the Bowery Poetry Club. He founded the band the Isotoners in 2003, and the band played the gay comedy rock circuit until 2005 when they discovered that there was no gay comedy rock band circuit. Ben has been playing solo in rock and comedy clubs, theaters, and festivals since 2006.
MARGOT LEITMAN Standing 5ft 6 by fourth grade, Margot developed a thick skin and a sharp sense of humor instead of learning how to play basketball. Measuring 5ft10 today, Margot's off beat, brutally honest, fearless comedy has earned her two ECNY "Best Female Stand Up" nominations and the "Joke of the Week" in Time Out New York. Margot appeared as various characters on "Late Night With Conan O' Brien," in addition to appearances on VH1's "Best Week Ever," ESPN's "Cheap Seats," AMC, the Style Network, E!, Comedy Central, MTV and NBC Broadband. Most recently she can be heard as the voice of "Fox" on the new Spike TV cartoon "The Team," as a featured comedian on Comedy Central.com's "Weekly Evil," and dancing in the current Mohegan Sun ad campaign. Every month she and Giulia Rozzi co-host the wildly popular, storytelling show "Stripped Stories". Margot has been featured in Glamour Magazine, and the books "Fifty Dates Worse Than Yours" and "The Complete Idiot's Guide to Jokes." She has written online for the Lifetime Network, College Humor.com, EHow.com and in print for Playgirl Magazine. Her stories will appear in three different anthologies slated for publication in 2008/2009. She currently teaches storytelling through the UCB Theatre.
One Night Only! Theater: Sage Theater
Google Maps Cost:$15.00 at door, $12.00 In Advance
Buy Tickets Online or Call: Powella Productions at 718-482-8790
Company: Powella Productions' LionHearted Players Official Web Site: www.lionheartedplayers.com


FDA initiates action in mid-day meal food poisoning at Mapusa
Mapusa: Food and Drugs Administration department swung into action 45 students of two high schools in Mapusa town, suffered poisoning through the food provided under mid-day meal scheme.
Around 45 students from two High Schools – Janta School and Ganesh Vidya Mandir – both located in Mapusa town complained of uneasiness after they consumed food under State sponsored mid day meal scheme. The formal complaint was filed with Mapusa police by managements of both the schools.
State FDA Minister Vishwajit Rane said that the team of the department officials was immediately rushed to the high school to check the sample of the food supplied by local self help group to the students.
He said that the team of FDA officials also inspected the premises of the self help group where the food was prepared.
"It was learnt that mid day meal at Janata School was supplied by Shri Ram Self Help Group," he said adding that out of total 438 students from the school who consumed the meal, 38 were affected.
"On inspecting the premises of the self help group, it was noted that they have shifted to new place and they could not produce the licence from FDA. The self help group was ordered to immediately stop the operations," the minister said.
The team also revealed that the food for Ganesh Vidya Mandir was supplied by Rashtroli Mahila Mandal. In this school, out of 350 students, seven were affected with the food poisoning. "several deficiencies were also found in the kitchen of this self help group, who were asked to comply with the directions of FDA," he said.
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The Cessation in Pregnancy Incentives Trial (CPIT): study protocol for a randomized controlled trial
David M Tappin1,
Linda Bauld2,
Carol Tannahill3,
Linda de Caestecker4,
Andrew Radley5,
Alex McConnachie6,
Kathleen Boyd7,
Andrew Briggs7,
Liz Grant8,
Alan Cameron9,
Susan MacAskill2,
Lesley Sinclair2,
Brenda Friel4 &
Tim Coleman10
Seventy percent of women in Scotland have at least one baby, making pregnancy an opportunity to help most young women quit smoking before their own health is irreparably compromised. By quitting during pregnancy their infants will be protected from miscarriage and still birth as well as low birth weight, asthma, attention deficit disorder and adult cardiovascular disease. In the UK, the NICE guidelines: 'How to stop smoking in pregnancy and following childbirth' (June 2010) highlighted that little evidence exists in the literature to confirm the efficacy of financial incentives to help pregnant smokers to quit. Its first research recommendation was to determine: Within a UK context, are incentives an acceptable, effective and cost-effective way to help pregnant women who smoke to quit?
This study is a phase II exploratory individually randomized controlled trial comparing standard care for pregnant smokers with standard care plus the additional offer of financial voucher incentives to engage with specialist cessation services and/or to quit smoking during pregnancy.
Participants (n = 600) will be pregnant smokers identified at maternity booking who, when contacted by specialist cessation services, agree to having their details passed to the NHS Smokefree Pregnancy Study Helpline to discuss the trial. The NHS Smokefree Pregnancy Study Helpline will be responsible for telephone consent and follow-up in late pregnancy. The primary outcome will be self reported smoking in late pregnancy verified by cotinine measurement. An economic evaluation will refine cost data collection and assess potential cost-effectiveness while qualitative research interviews with clients and health professionals will assess the level of acceptance of this form of incentive payment. The research questions are: What is the likely therapeutic efficacy? Are incentives potentially cost-effective? Is individual randomization an efficient trial design without introducing outcome bias? Can incentives be introduced in a way that is feasible and acceptable?
This phase II trial will establish a workable design to reduce the risks associated with a future definitive phase III multicenter randomized controlled trial and establish a framework to assess the costs and benefits of financial incentives to help pregnant smokers to quit.
Current Controlled Trials ISRCTN87508788
Smoking during pregnancy increases miscarriage and stillbirth, accounting for up to 4000 UK deaths annually, and pre-term birth and low birth weight leading to perinatal morbidity [1]. A third of excess stillbirths and post-natal deaths associated with living in deprived areas are explained by smoking during pregnancy [2]. In Scotland 70% of women have a baby [3], making pregnancy an opportunity to help most women quit before their health is permanently compromised. In 2009, 24% of women booking for maternity care self-reported as current smokers [4]. Less than 1 in 20 of these women quit [5]. A study in the USA [6] in 2001 calculated the additional first year costs to health services as $1200 per smoker. Smoking is a major preventable cause of premature mortality for the mother, and lifelong benefits of quitting for children include reduced incidence of asthma and attention deficit disorder.
Following the 1998 White paper 'Smoking Kills', evidence-based National Health Service (NHS) smoking cessation services using behavioral support were developed [7–9] and now exist throughout Scotland [5]. Most of these services aim to provide tailored support (referred to in this paper as NHS Smokefree Pregnancy Services - NSPS) to pregnant women on a one-to-one basis, and evidence suggests that such interventions during pregnancy are effective [10]. Nicotine replacement therapy (NRT) is also offered, although its efficacy in pregnancy is not yet clear [10]. In Greater Glasgow & Clyde (GG&C), with 15,000 pregnancies per year, pregnant smokers identified at maternity booking are currently routinely referred to the NSPS on an 'opt-out' basis, without consent for transfer of contact information [7]. This practice is in keeping with the recent National Institute for health and Clinical Excellence (NICE) guidelines in the UK [11]. Women are then contacted by NSPS advisers who ask if they would like to quit and offer a face-to-face appointment in a clinic or home setting. If the client attends they set a quit date and a risk assessment for use of NRT during pregnancy is performed.
Participation figures for areas with recognized specialist smoking cessation in pregnancy services from a Scotland-wide audit are shown below [5]:
Estimated number of pregnant smokers at maternity booking [12], 8170 (100%).
Smokers identified by self report at routine booking questionnaire, 6128 (75%).
Smokers referred to specialist pregnancy cessation services, 3188 (39%).
Smokers engaged - face to face contact with specialist cessation service, 763 (10%)a.
Smokers who 'set a quit date', 779 (10%).
Smokers who had quit 4 weeks later, 236 (3%).
aDifferent denominator.
In Scotland, all women who book for maternity care are asked if they are current, former or never smokers (B above). At present 25% deny their habit (A to B) [12]. This problem is being addressed by routinely testing all pregnant women at maternity booking for carbon monoxide using a breath test [11]. Only half were referred (B to C) due to busy clinics and perceived client disapproval. Only 10% reached specialist cessation services such as those available in Glasgow (D). Nearly all of these 'set a quit date' (E) and 3 in 10 (F) quit. Some improvement (E to F) may be possible as 4 in 10 quit [13] with support from NHS cessation services in other parts of the UK.
Incentives are thought to increase participation and engagement [14, 15], retention [16, 17], and cessation [15–18]. If offered incentives, women who deny smoking may report as current smokers (A to B). Clients may self-refer or ask to be referred (B to C). With incentives, a greater proportion may engage (C to D) [5]. Improvement in the numbers quitting (D to F) will follow. In Scotland, when more pregnant smokers were referred, more engaged and more quit [5].
A 2009 Cochrane systematic review of interventions for promoting smoking cessation during pregnancy [10] asked: Do interventions improve quit rates? Are some interventions better than others? Figure 1 is a funnel plot describing the outcome from all included trials showing intervention better than control to the left. Fewer small trials on the right (control better than intervention) indicates some publication bias so the pooled risk ratio 0.94 may overestimate any combined positive effect. The four incentives trials showed significantly better outcomes than other interventions: pooled risk ratio 0.76 (95% confidence interval (CI) 0.71 to 0.91).
Funnel plot. Figure 1 is a funnel plot of all studies included in the Cochrane systematic review: interventions for promoting smoking cessation during pregnancy [10]. The overall risk ratio for smoking cessation in each study is plotted on the x axis. The sample size of each study is plotted on the y axis. The plot illustrates possible publication bias with a gap caused by 'missing' studies upsetting the symmetry on the right hand side of the figure, indicating that small negative studies may not have reached the point of publication. Diamond shaped symbols indicate individual randomization whereas square symbols indicate that cluster randomization was used in the trial. The four black diamond shapes on the left side represent the four incentives trials included in the review. The dashed vertical line crosses the x axis at the weighted mean risk ratio of smoking reduction in all studies comparing intervention with control – 0.94 (95 % confidence interval 0.93 to 0.95).
However, the incentives trials are all from the USA. The first trial was conducted 25 years ago and only included incentives as a minor part of an extensive intervention. Other incentives trials were small [16–18] and did not have a 'no incentive' control group [17, 18]. None attempted to measure change in participation or engagement with an intervention. The NICE guidelines [11] issued in June 2010 highlighted that little evidence exists in the literature to confirm the efficacy of financial incentives to help pregnant smokers to quit. Its first research recommendation was: "Within a UK context, are incentives an acceptable, effective and cost-effective way to help pregnant women who smoke to quit?"
Since 2007, NHS Tayside in Scotland has piloted an incentives model - £12.50 per week of supermarket vouchers - to reward smoking cessation from quit date to 3 months after birth. The total payment for quitters is up to £650. The project has no formal contemporaneous control group but the number of women accessing cessation support has increased since incentives were introduced [19]. Women access the service at their local pharmacies, which provide NRT as well as support and validate whether the client has stopped smoking. This information initiates a payment onto a store card. During 2009, 169 (14%) of about 1200 pregnant smokers [5] joined the program (the equivalent of engagement) and 94 (8%) women had quit smoking 4 weeks later; 42 were still quit at delivery (personal communication, Andrew Radley). This cessation rate is higher than those obtained by other Scottish smoking cessation in pregnancy services, where the average quit rate at 4 weeks is 3%, and the best 5% [5]. A feasibility study for an incentives trial in Glasgow reported in January 2009 [20]. It explored how the Tayside program could be adapted for service configuration in Glasgow. The feasibility study provided the foundation for development of this trial.
This phase II trial will provide the tools required to run a future appropriately powered definitive phase III multicenter randomized controlled trial. The aim of that future phase III trial will be to establish whether or not incentives increase engagement with services, quit attempts and successful cessation to provide a more cost-effective pregnancy smoking cessation service model generalizable to the whole UK and beyond.
Design and methodology
In 2010 there were 58,051 births in Scotland with 14,155 (24%) to mothers resident in NHS GG&C Health Board area. Twenty-six percent of births in Scotland are to women who live in the most deprived quintile, whereas in GG&C it is 44% [21]. Of the most deprived women who were asked, 35% self reported that they smoked at maternity booking compared with 7.1% of the least deprived [22]. Overall, in GG&C 25% of women self report as current smokers at maternity booking.
The study is designed as a phase II single blinded (outcome assessor blind to randomization status at follow-up telephone contact) individually randomized controlled trial. The procedures are illustrated schematically in Figure 2 and detailed in the text.
Flow diagram for Cessation in Pregnancy Incentives Trial (CPIT). Figure 2 projects the flow of pregnant women through the trial over a 12-month period. In the NHS Greater Glasgow & Clyde study area, 15,000 pregnancies are recorded at maternity booking; 5,000 are to smokers, some who conceal their habit, and 3,000 are identified at maternity booking by self-report as current smokers. Their information is routinely passed to NHS Smokefree Pregnancy Services (NSPS) using an automated system. Attempt is made to contact all self reported smokers. We estimate that 500 will not be contactable by NSPS and that 500 will decline permission for their details to be passed to the NHS Smokefree Pregnancy Study Helpline (Study Helpline). Once details have been passed, 500 will not be contactable leaving 1,500 contacted by the Study Helpline. We expect that 600 to 900 will decline consent leaving 600 to 900 who agree to enroll in the study over 12 months. Of these, 300 will be randomly allocated to the intervention group to be offered incentive payments as well as standard care to stop smoking during pregnancy and 300 will be randomly allocated to receive the offer of standard care without incentive payments to quit smoking.
What is the likely therapeutic efficacy of financial incentives to encourage women to attend specialist cessation services, to set a quit date, to quit smoking and be abstinent at 34 to 38 weeks gestation towards the end of pregnancy?
Is individual randomization an efficient trial design without compromising validity through bias due to differential follow-up of disaffected control arm participants?
Health economic study
Are incentives potentially a cost-effective means of helping pregnant women to stop smoking?
Can incentives be introduced in a way that is feasible and acceptable to women and service providers and are there any unintended consequences?
NHS Smokefree Pregnancy Services Greater Glasgow & Clyde Health Board area
At their maternity booking appointment pregnant women in NHS GG&C are asked for consent for screening which includes procedures to identify and offer treatment to current smokers – self report and routine carbon monoxide breath test with follow-up by NSPS. All women with either a carbon monoxide level of 5 ppm and above or self reported as current smokers (at least 1 cigarette in the last week) are notified to NSPS using a rapid electronic system. NSPS advisers contact these women by telephone and offer a smoking cessation counseling service which utilizes 'Withdrawal Oriented Therapy' [23]. Support includes a face-to-face appointment, weekly telephone support for 4 weeks and the offer of NRT dispensed by local pharmacies free of charge to support a quit attempt for up to 12 weeks.
Trial inclusion criteria
Participants must satisfy the following criteria to be included in the study:
· age at least 16 years and pregnant less than 24 weeks gestation at maternity booking.
· self report as current smokers.
· have a carbon monoxide breath test result of 7 ppm or greater - NICE guideline level for referral of pregnant smokers – PH26 [11].
· live in the NHS GG&C Health Board area.
· give permission for their contact details to be passed to NHS Smokefree Pregnancy Study Helpline.
· be able to understand and speak English in order to provide verbal telephone consent to take part in the trial.
Early in the first telephone contact call from an NSPS adviser, eligible smokers will be given information about the trial and asked to give their verbal permission for contact details to be passed to the NHS Smokefree Pregnancy Study Helpline so that formal trial telephone consent procedures can take place. The Caldicott Guardian has approved this verbal permission required to pass this contact information. Those who give permission for contact details to be passed will be sent a letter and a trial information sheet outlining the nature and importance of the trial. The NSPS adviser will then continue with standard treatment and follow-up procedures.
We will enroll 600 eligible pregnant smokers to this phase II trial over a 12 month period. This is illustrated in Figure 2 based on existing throughput from local services in the study area and is a conservative time period taking into account smokers not identified or referred and those who decline consent to take part in the incentives trial. We expect high enrollment of eligible smokers and that knowledge of the trial will increase eligible smokers who agree to consider cessation during this pregnancy and consent to take part in the trial.
Consent and randomization procedure
At least 7 days after the first NSPS contact call, eligible smokers who allow their contact details to be passed on will be contacted by the Helpline to undergo formal consent procedures. Telephone contact will be attempted on three occasions at the time slot preferred by the client - weekday, evening or weekend - after which no further attempts at enrollment will be made. During the consent call potential participants will be fully informed about the nature and relevance of the trial, and exactly what will be involved if they agree to take part. Early in the consent call potential participants will be asked to provide information not asked for at maternity booking including questions measuring level of addiction to nicotine and partner smoking habits. Audio recordings of the consent process will be stored in accordance with Good Clinical Practice guidelines. Eligible smokers who consent to take part in the trial will be sent a written copy of their consent form. Individuals who give informed consent will be enrolled in the trial and randomized. The random allocation will be fed back to the participant. The Helpline adviser cannot influence or predict the random allocation which is integrated into the clinical information system. It will also provide a concealed (not available to the NHS Smokefree Pregnancy Study Helpline adviser during the consent call) random date between 34 and 38 weeks gestation for this pregnancy when the Helpline will contact the participant again to ascertain the primary outcome measure of self reported smoking during the last 8 weeks which will be corroborated by cotinine measurement.
Baseline (pre-randomization) data collection
Identification and contact
Patient name, address, full postcode, telephone numbers (home, mobile, office).
Best time to call, best number, estimated date of delivery, name of referrer, General Practitioner name.
Self reported smoking status at maternity booking, carbon monoxide breath test level at maternity booking, date of carbon monoxide reading, age at first telephone contact, English speaking, gestation at booking, consent, copy of consent form sent.
Smoking addiction level and other
Fagerstrom questions [24] score out of 10, parity, partner smokes.
Randomization will be embedded within the trial database. The random allocation sequence will be generated by the Robertson Centre for Biostatistics, University of Glasgow (part of the Glasgow Clinical Trials Unit), using the method of randomized permuted blocks, with a block length of 4. In addition, a random date between 34 and 38 weeks gestation for each pregnancy will be generated as the date for primary outcome data collection. Patient details will be entered prior to randomization so that the allocation is concealed from Helpline staff and the client until after the patient has been enrolled in the study and provided baseline information. The participant will be informed of their random allocation group towards the end of the Helpline 'trial consent' telephone contact call, but will not be informed of the date when their primary outcome data will be collected.
For a period during trial recruitment an extra consent question will be 'turned on' during the consent call asking clients also to consent to being contacted by trial staff for the purposes of one-to-one interviews to fulfill qualitative aspects of this research trial.
Voucher incentive payments
Those allocated to the intervention group will be offered financial incentives - Love2Shop vouchers - that can be redeemed in a wide array of UK shops but not used for the purchase of cigarettes or alcohol. The total amount available is £400 if women remain abstinent at each monitoring point. Women will receive incentive payments outlined below:
£50 for attending a face-to-face appointment with their NSPS adviser and setting a quit date;
£50 if quit 4 weeks after their quit date corroborated by a carbon monoxide breath test result less than 10 ppm collected by a research nurse;
£100 if quit after 12 weeks corroborated by a carbon monoxide breath test collected by a research nurse;
£200 if they self report quit for at least 2 months when contacted for primary outcome assessment by the Helpline at 34 to 38 weeks gestation. This will be corroborated by a carbon monoxide breath test result less than 10 ppm collected by a research nurse.
Trial participation payments
In order to minimize loss to follow-up, particularly among control participants, £25 will be given to all participants if they provide primary outcome information (and required samples to corroborate abstinence) at 34 and 38 weeks gestation.
Quantitative data collection
Smoking status at 34 to 38 weeks gestation, towards the end of pregnancy. Follow-up telephone contact will be attempted by NHS Smokefree Pregnancy Study Helpline at a random date between 34 and 38 weeks gestation allocated at the time of the initial randomization. A patient record check will be made by the NHS Smokefree Pregnancy Service administrator looking for stillbirth, miscarriage or patient death the week prior to the telephone contact at 34 to 38 weeks gestation. Miscarriage or stillbirth may not preclude a woman from receiving vouchers if they are in the intervention group.
Three attempts will be made to contact participants. If no contact is possible the participants will be followed up by the research nurse either by telephone or by a home visit after a contact detail check with the participant's General Practitioner. If participants self report as non-smokers then a research nurse will make an appointment to collect urine and saliva for cotinine estimation (as well as a breath test for carbon monoxide to trigger the incentive payment).
If successful contact is made, the participant will be asked: 'Have you smoked in the last 8 weeks?' If yes 'Have you smoked more than 5 cigarettes in that time?' Self report will be corroborated by cotinine estimation on saliva and urine. Urine (cut-off 44.7 ng/ml) or saliva (cut-off 14.2 ng/ml) cotinine will be measured by ABS laboratories limited (abslabs@biopark.org.uk).
The important aspect of the primary outcome for this phase II trial is the proportion of participants successfully followed up from the intervention but particularly the control group. If acceptable levels (about 90%) of participants can be successfully followed up with a similar proportion in the intervention and control groups, then individual randomization can be accepted as a design choice for a future phase III trial that does not produce significant bias due to differential loss to follow-up between groups.
Engagement with specialist pregnancy cessation services is achieved if the participant arrives at a first face-to-face appointment with the NSPS adviser and sets a quit date.
Quit at 4 weeks after quit date will be ascertained with the question 'Have you smoked in the last 2 weeks, even a puff?' at routine telephone contact by the NSPS adviser. This will be corroborated by a carbon monoxide breath test collected at routine pharmacy visits to collect NRT. These data will be available from both intervention and control groups.
Birth weight
The best methods to gather these data efficiently will be examined and tested. Maternal height and weight is recorded routinely at maternity booking and will be used to help clarify birth weight differences during data analysis. Babies of smokers are on average 300 g (10%) lighter than babies born to non-smokers [25].
We do not anticipate the provision of extra finance to participants will have any adverse effects. We are not systematically documenting adverse events that happen during pregnancy. We are, however, examining unintended consequences formally using in-depth interviews with a sample of enrolled clients. Such possible unintended consequences include, for instance, taking up smoking prior to maternity booking in order to receive incentive payments by stopping afterwards.
Economic analysis will be undertaken alongside the trial, utilizing the costs, resource use and effectiveness data generated within the trial. For example, the cost of financial incentives, NRT, service delivery, and so on, will be collected and combined with resource use data. The number of quitters at the end of the trial will be combined with the cost data to calculate the incremental cost per late pregnancy quitter. The secondary outcome measure of child birth weight is strongly related to health care costs. Birth weight will be used to determine any difference in weight and therefore health care costs between neonates of mothers in the intervention group compared to mothers allocated to the control group.
Health economic assessment
A within-trial analysis will explore the incremental cost per late pregnancy quitter, followed by a longer term analysis incorporating the cost to the NHS of any difference in birth weight due to smoking and looking at potential lifetime quality-adjusted life year (QALY) gains to the mother and child.
A health economic model we previously developed [26] (which uses a Markov design to model the lifetime likelihood and impact of cessation, expressing the long-term health benefits of quitting smoking in terms of QALYs saved and the potential long-term reduced costs to the health service of cessation) will be used. This model will be adapted to incorporate the trial information and relevant published evidence in order to capture the short and longer term costs and health gains for both mother and child of smoking cessation during pregnancy. The outcomes will be presented in terms of the incremental cost per QALY saved. The model will be analyzed probabilistically in order to characterize uncertainty in the parameters, and estimate confidence limits around the cost and effectiveness outcomes. Areas of uncertainty identified within the model will help inform decisions about the potential value of future research. This model will ascertain whether any (and what type of) data should be collected to inform a more definitive economic evaluation and contribute to the optimal design of a Phase III trial.
Analysis of outcomes will be by intention-to-treat, as the intervention is the offer of financial incentives to engage with cessation services and to quit smoking.
Differences by subgroup (maternity unit, deprivation score, age group, and so on) will be explored.
The study is not designed to be able to detect a specified difference in the primary outcome of quit rate at 34 to 38 weeks gestation. The main objective is to inform the feasibility and design of a future definitive trial. However, assuming a quit rate of 4% in the usual care arm of the study, then with 600 participants the study will have 90% power to detect an increase in quit rates to 11.4%, or 80% power to detect an increase to 10.2%, based on a continuity-corrected χ 2 test at a 5% level of significance. Even if these outcome rates were achieved in this study, a Phase III study would be required to demonstrate that the intervention can be effective in other settings.
Overview of qualitative research components
Qualitative outcomes
The qualitative research will take the form of a process evaluation designed to inform aspects of the proposed trial. It will contribute to:
· assessing the feasibility and acceptability to women and service providers of using incentives to promote cessation during pregnancy (including identification of barriers and facilitators).
· identifying any unintended consequences of participation.
· exploring responses to randomization approaches
· providing guidance on how the intervention might be modified for the Phase III randomized controlled trial.
Interviews will be conducted with small samples of (i) pregnant women and (ii) relevant professionals by researchers at Stirling University led by Susan MacAskill. This work will expand on qualitative research already undertaken with clients and professionals in relation to 'Give it up for Baby', the incentives scheme in Tayside [19].
Qualitative interviews will be conducted with pregnant women and professionals using semi-structured topic guides developed in line with the research aims. Topics will not be explored in a prescriptive manner but as part of an open discussion. This flexible format will enable additional salient topics and insights to emerge. In broad terms, the focus for the different respondent groups will be as follows:
One-to-one interviews with pregnant women (all of whom have engaged with the service) will explore views on issues around the delivery and promotion of the cessation service, response to incentive features and randomization, and any unintended consequences. Those interviewed prior to the trial start will be asked to respond to the concept of the incentives and the trial elements in addition to routine service elements, whilst those interviewed during the trial will also be asked to respond to these elements but based on personal experience of the trial.
Focus group interviews with pregnant women (smokers/recent ex-smokers) interviewed before the trial starts will also explore views on issues around the delivery and promotion of the cessation service, response to incentive features and randomization, and any unintended consequences. Responses can incorporate personal experiences, but will largely be based on response to the concept of these issues.
Interviews with professionals will explore issues around implementation of the intervention and the trial elements, identify challenges and ways they have been overcome, and perceived response among participants.
With the participants' consent, all interviews and focus group discussions will be recorded as digital audio files, which will then be transcribed in full for thematic analysis. Transcripts will be organized using a thematic framework based on topics specified in the topic guide and emerging themes identified through a process of familiarization with transcript texts.
Sample and recruitment for the qualitative element
Prior to the trial starting, up to 10 pregnant smokers will be recruited from amongst those already in contact with NSPS in Glasgow. Women will be informed about the study by specialist advisers on smoking in pregnancy and asked if they are interested in participating. Those interested will be provided with an information sheet and will be asked if their details can be passed to the lead qualitative researcher. Those who consent to their details being sent on will be contacted by phone to address any queries and to arrange an interview time and place. Alternatively, if they consent at the time of the initial information being provided, interviews can be conducted following their second session with the specialist advisor. Interviews will be conducted face to face and written consent obtained.
In addition, two one-off focus groups (4 to 8 respondents each) with pregnant women (incorporating smokers/recent ex-smokers) will be conducted. Women will be recruited by the researcher through ante-natal classes or other appropriate groups attended by pregnant women and again explanations will be given and consent sought to participate.
During the trial an additional 20 women will be interviewed after they have engaged with the trial. These will be different women from those interviewed prior to the trial. Pregnant smokers will be informed about this part of the study by the NHS Smokefree Pregnancy Study Helpline and asked if they are interested in participating in the interviews as part of the initial consent process. Details of those who express an interest and consent to be contacted will be passed to the research team. Points at which individuals will be interviewed will be spread across the pregnancy (that is, at around 4, 12 and 20 weeks post-set quit date). Mechanisms will be in place to ensure there are no contraindications prior to re-contacting those to be interviewed in later pregnancy (for example, any adverse pregnancy outcomes such as miscarriage). Both continued participants and those who have dropped-out will be included in the sample.
Respondents will be recruited from two hub areas in Glasgow and Clyde. All pregnant women participants will be offered £20 in recognition of their contribution to the study.
Professionals will also be interviewed as part of the qualitative study. They will be approached through appropriate organizational structures, facilitated by study co-applicants. Information sheets will be provided and consent obtained. The professional sample is intended to reflect a range of perspectives on implementation and the conduct of the trial. They will therefore include: pregnancy smoking cessation advisor(s) and manager, Clinical Research Facility nurse(s), interviews with the NHS Stop Smoking Study Helpline staff/managers, community midwives and manager, and community pharmacy facilitator(s). Professionals will be interviewed by telephone or face to face.
In Scotland, up to a third of pregnant women smoke throughout pregnancy. This is responsible for a third of miscarriages, still births and sudden infant deaths during the first year of life. There would be significant long-term health gains for mother and child if smokers quit during pregnancy. At present, less than 10% of pregnant smokers take up the offer of free smoking cessation services and only 3% quit during pregnancy. Modest incentive payments to engage with cessation services and/or to quit smoking may provide a substantial benefit by decreasing pregnancy health care costs and first-year health care costs. If women stay smoke-free, long-term health care costs will be substantially reduced. The results of this phase II trial will reduce the risks associated with funding a definitive phase III multicenter trial. The phase III trial will examine the costs and benefits of providing financial incentive payments for smoking cessation during pregnancy.
Ethics approval was received from West of Scotland REC2 on 25 May 2011.
Caldicott guardian approval was given on 3 February 2011 to allow NSPS GG&C to pass information to the NHS Smokefree Pregnancy Study Helpline if the client gives verbal permission that contact details can be passed.
A major amendment to the trial protocol was approved on 6 March 2012 to allow use of anonymized qualitative interview data by the Health Technology Assessment Programme 10/31/02 BIBS: Benefits of Incentives for Breastfeeding and Smoking cessation: A platform study for a trial.
Trial organization
The overall scientific aspects of the project will be managed by a Steering Committee. The Steering Committee will include the investigators above. The Steering Committee will take all executive decisions.
The responsibility of the Steering Committee is to ensure the scientific integrity and quality of the project. To achieve this, the specific responsibilities of the Steering Committee include: maintaining adherence to the study protocol; approving changes to study protocol if required; reviewing quality assurance indicators; monitoring study recruitment and the overall study timetable; advising, as required, on specific scientific items that may arise; compliance with legislation; adherence to research governance; reporting to funders; approving publication and dissemination strategies.
The Steering Committee will meet every 6 months.
Project Management Group
A Project Management Group (comprising as required principal investigators, a trial manager, a trial administrator, a senior manager from NSPS, a data manager from NHS Research and Development, a statistician, a senior representative from NHS Stop Smoking Study Helpline, a senior manager from NHS GG&C Research and Development, a health economist, a senior qualitative researcher) will run the trial on a day-to-day basis to ensure the smooth operation of the project. Review meetings will be held with other members of the team as appropriate.
The responsibilities of the Project Management Group include: establishing and monitoring recruitment of participants; distributing and supplying data collection forms and other appropriate documentation for the trial; data collection and management; data entry and cleaning; data analysis; organizing and servicing the Trial Steering Committee.
An independent Data Monitoring Committee will not be established as adverse events related to the financial incentives intervention are not envisaged and are not being systematically collected.
Data Co-ordinating Centre
The Data Co-ordinating Centre will be based at the Paediatric Epidemiology and Community Health Unit, Glasgow University. The responsibilities of the Data Co-ordinating Centre are to set up and run systems for data entry, data verification and the checking of errors and overdue data reports.
Callcredit plc
Callcredit plc, Leeds UK, will design and build the web based portal for data entry comprising the main Electronic Data Capture system. This system will allow NHS and research staff to enter data in a timely fashion triggering voucher incentive payments dispatched by Callcredit.
NHS Stop Smoking Study Helpline
NHS Stop Smoking Study Helpline will provide call centre services: the consent call for participant enrollment, and the final call to determine the primary outcome (self reported smoking at 34 to 38 weeks gestation).
NHS Research and Development Glasgow & Clyde
NHS Research and Development are supporting this trial by providing extra research nursing support for participant enrollment and follow-up and project assistance for data entry.
The Robertson Centre for Biostatistics, University of Glasgow
The Robertson Centre is part of the Glasgow Clinical Trials Unit, and will provide statistical analysis and reporting for the study.
NHS Smoking in Pregnancy Services
NSPS GG&C are discussing the trial with participants and asking permission for contact data to be passed outwith the NHS to The Listening Company Glasgow Scotland (a call centre with extensive experience working with the NHS and who are known for the trial as the NHS Stop Smoking Study Helpline) for the consent call. NSPS staff are providing an encrypted list of potential participants to the NHS Stop Smoking Study Helpline on a weekly basis. They are providing cost data for the economic analysis.
The primary results of the trial will be published with authorship in relation to specific participation in the study, with the name order to be presented by the principal investigators for consideration by the Trial Steering Committee. Suggested revisions in order of authors should meet with the approval of the principal investigators. Publications in specific areas of the study or on methodological aspects can be led by co-investigators in their area of expertise subject to approval by the Trial Steering Committee and the principal investigators. The requirements for authorship will follow recommended practice in journal guidelines.
Encryption defined by NHS GG&C security management will be in place to pass data for potential participants from NSPS to NHS Smokefree Pregnancy Study Helpline, a process agreed by the Caldicott Guardian. Both NHS Smokefree Pregnancy Study Helpline and CallCredit plc have long histories of managing Government-related services and are able to demonstrate their commitment to data security and quality management through their ISO27001 and ISO9001 accreditations. Their ISO27001 accredited Information Security Management Systems demand that all of their systems and processes are maintained with confidentiality, integrity and availability of data at the core. In addition both companies are ISO9001 accredited, the internationally recognized standard for Quality Management Systems. During and after data analysis participants will be identified by their trial number to ensure confidentiality.
Recruitment started in December 2011. On 9 june 2012, 199 of 600 were enrolled in the trial.
David Tappin (Co-Principal Investigator): Professor of Clinical Trials for Children based at the Paediatric Epidemiology and Community Health Unit. Will co-ordinate and manage the overall running of the trial and will be closely involved in data analysis and paper writing and dissemination of results.
Linda Bauld (Co-Principal Investigator): Professor of Socio-Management Stirling Management School and U.K. Centre for Tobacco Control Studies. Has extensive experience of quantitative and particularly qualitative work related to smoking cessation. She will support the trial on a day to day basis and be involved in paper writing and dissemination of results
Carol Tannahill: Director of the Glasgow Centre for Population Health. She will support the trial and give guidance.
Linda de Caestecker: Director of Public Health Greater Glasgow and Clyde Health Board. She will support the trial set-up and liaison with NHS Smokefree Pregnancy Services and NHS Research and Development, Greater Glasgow and Clyde.
Andrew Radley: Public Health Pharmacist Tayside. Established 'Give it up for baby' an innovative service development providing financial incentives for pregnant smokers to quit in Tayside. He will provide advice from his experience providing financial incentives to help pregnant smokers to quit.
Alex McConnachie: Assistant Director of Biostatistics, Robertson Centre for Biostatistics has extensive experience of data analysis and study design for clinical trials. He will be responsible for analyzing the final dataset.
Kathleen Boyd: A health economics research fellow who has planned and will undertake the health economic evaluation.
Andrew Briggs: Professor of Health Economics has extensive experience investigating the health economic effects related to clinical trials. He will be responsible for the health economic aspects of the trial.
Alan Cameron: Professor of Obstetrics has been involved in many studies related to obstetric care. He will have responsibility for the obstetric service aspects of the project.
Liz Grant: Runs the pharmacy aspects of smoking cessation services for NHS Greater Glasgow and Clyde Health Board
Susan MacAskill: Is a senior qualitative researcher with extensive experience of assessing smoking cessation intervention strategies. She will be responsible for the qualitative aspects of the study.
Lesley Sinclair (Trial Manager): Has experience of data management and the management of clinical trials. She will run the trial on a day to day basis.
Brenda Friel: Is health improvement senior, Smokefree Services, who runs the NHS Smokefree Pregnancy Services in Greater Glasgow and Clyde. She has been pivotal in ensuring that this trial runs well. She has been involved in planning and supporting all aspects of the trial process.
Tim Coleman: Is a senior researcher who has run trials of smoking cessation interventions during and outwith pregnancy. He will provide an overview for the other investigators.
CPIT:
Cessation in Pregnancy Incentives Trial
GG&C:
Greater Glasgow & Clyde
NHS:
National Institute for health and Clinical Excellence
NRT:
NSPS:
NHS Smokefree Pregnancy Services
quality-adjusted life year.
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Information Services Division NHS National Services Scotland: Births and Babies: Smoking and pregnancy. 2009,http://www.isdscotland.org/isd/2911.html,
Tappin DM, MacAskill S, Bauld L, Eadie D, Shipton D, Galbraith L: Smoking prevalence and smoking cessation services for pregnant women in Scotland. Subst Abuse Treat Prev Policy. 2010, 5: 1-10.1186/1747-597X-5-1.
Miller DP, Villa KF, Hogue SL, Sivapathasundaram D: Birth and first year costs for mothers and infants attributable to maternal smoking. Nicotine Tob Res. 2001, 3: 25-35.
McGowan A, Hamilton S, Barnett D, Nsofor M, Proudfoot J, Tappin DM: 'Breathe': the stop smoking service for pregnant women in Glasgow. Midwifery. 2010, 18: 500-510.
Bryce A, Butler C, Gnich W, Sheehey C, Tappin DM: CATCH: development of a home-based midwifery intervention to support young pregnant smokers to quit. Midwifery. 2009, 25: 473-482. 10.1016/j.midw.2007.10.006.
Tappin DM, Lumsden MA, Gilmour WH, Crawford F, McIntyre D, Stone D, Webber R, MacIndoe S, Mohammed E: Randomised controlled trial of home based motivational interviewing by midwives to help pregnant smokers quit or cut down. BMJ. 2005, 331: 373-377. 10.1136/bmj.331.7513.373.
Lumley J, Chamberlain C, Dowswell T, Oliver S, Oakley L, Watson L: Interventions for promoting smoking cessation during pregnancy. Cochrane Database Syst Rev. 2009, 3: CD001055-
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Shipton D, Tappin DM, Vadiveloo T, Aitken DA, Chalmers J: Reliability of self reported smoking status by pregnant women for estimating smoking prevalence: a retrospective, cross sectional study. BMJ. 2009, 339: b4347-10.1136/bmj.b4347.
Judge K, Bauld L, Chesterman J, Ferguson J: The English smoking treatment services: short-term outcomes. Addiction. 2005, 100 (Suppl 2): 46-58.
Cahill K, Perera R: Competitions and incentives for smoking cessation. Cochrane Database Syst Rev. 2008, 3: CD004307-
Volpp KG, Troxel AB, Pauly MV, Glick HA, Puig A, Asch DA, Galvin R, Zhu J, Wan F, DeGuzman J, Corbett E, Weiner J, Audrain-McGovern J: A randomized, controlled trial of financial incentives for smoking cessation. N Engl J Med. 2009, 360: 699-709. 10.1056/NEJMsa0806819.
Donatelle RJ, Prows SL, Champeau D, Hudson D: Randomised controlled trial using social support and financial incentives for high risk pregnant smokers: Significant Other Supporter (SOS) program. Tob Control. 2000, 9 (Suppl III): iii67-iii69.
Higgins S, Alessi S, Dantona R: Voucher-based incentives: a substance abuse treatment innovation. Addict Behav. 2002, 27: 887-910. 10.1016/S0306-4603(02)00297-6.
Heil S, Higgins S, Berstein I: Effect of voucher based incentives on abstinence from cigarette smoking and fetal growth amongst pregnant women. Addiction. 2008, 103: 1009-1018. 10.1111/j.1360-0443.2008.02237.x.
Give It Up For Baby: The NSMC - National Social Marketing Centre.http://thensmc.com/resources/showcase/give-it-baby,
MacAskill S, Ferguson J, Bauld L, Tappin D: Incentives to Engage Pregnant Smokers with Specialist Smoking Cessation Services: Feasibility Study in NHSGGC - Report Stirling. 2009, University of Stirling and The Open University, Institute for Social Marketing
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Heatherton TF, Kozlowski LT, Frecker RC, Fagerstrom KO: The Fagerstrom Test for Nicotine Dependence: a revision of the Fagerstrom Tolerance Questionnaire. Br J Addict. 1991, 86: 1119-1127. 10.1111/j.1360-0443.1991.tb01879.x.
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Bauld L, Boyd K, Briggs A, Chesterman J, Ferguson J, Judge K, Hiscock R: One year outcomes and a cost-effectiveness analysis for smokers accessing group-based and pharmacy-led treatment services. Nicotine Tob Res. 2011, 13: 135-145. 10.1093/ntr/ntq222.
Funding for this trial has been provided by: the Chief Scientist Office, Scottish Government; Glasgow Centre for Population Health; the Research and Teaching endowment fund of the Director of Public Health NHS Greater Glasgow & Clyde; the Royal Samaritan Endowment fund NHS Greater Glasgow & Clyde, the Yorkhill Children's Foundation; NHS R&D Greater Glasgow & Clyde.
Paediatric Epidemiology and Community Health Unit, Section of Child Health, Division of Developmental Medicine, Glasgow University, Yorkhill Campus, Glasgow, G3 8SJ, Scotland, UK
David M Tappin
Centre for Tobacco Control Studies, and School of Management, University of Stirling, Stirling, FK9 4LA, Scotland, UK
Linda Bauld
, Susan MacAskill
& Lesley Sinclair
Glasgow Centre for Population Health, 1st Floor, House 6, 94 Elmbank Street, Glasgow, G2 4DL, Scotland, UK
Carol Tannahill
NHS Greater Glasgow& Clyde, J B Russell House, Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow, G12 OXH, Scotland, UK
Linda de Caestecker
& Brenda Friel
Directorate of Public Health, NHS Tayside, Kings Cross Hospital, Clepington Road, Dundee, DD3 8EA, Scotland, UK
Andrew Radley
Robertson Centre for Biostatistics, Boyd Orr Building, University Avenue, Glasgow, G12 8QQ, Scotland, UK
Alex McConnachie
Institute of Health and Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ, Scotland, UK
Kathleen Boyd
& Andrew Briggs
NHS Greater Glasgow and Clyde, West House, Gartnavel Royal Hospital, Glasgow, G12 0XH, Scotland, UK
Liz Grant
R205 Level 2, Queen Mother's Hospital Tower Block, Glasgow, G3 8SJ, Scotland, UK
Alan Cameron
U.K. Centre for Tobacco Control Studies and NIHR School for Primary Care Research Division of Primary Care, University of Nottingham, Nottingham, NG7 2UH, Scotland, UK
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Correspondence to David M Tappin.
DT and LB conceived the study. DT, LB, CT, LDC, AB, AC, LG AR, SM, AM and TC were applicants for the funding. All authors were involved in designing the study and drafting the protocol. KB and AB designed the health economic aspects of the study. SM designed the qualitative aspects of the study. All authors read and approved the final protocol.
Tappin, D.M., Bauld, L., Tannahill, C. et al. The Cessation in Pregnancy Incentives Trial (CPIT): study protocol for a randomized controlled trial. Trials 13, 113 (2012) doi:10.1186/1745-6215-13-113
DOI: https://doi.org/10.1186/1745-6215-13-113


Fresh face on Dodge's Muscle Sedan.
By Matt DeLorenzo
The wraps have come off the and what's old has become new again. Taking a page from the second generation Charger—that iconic two-door coupe from the late 1960s-early 1970s, the range-topping rear-drive 4-door sedan borrows the side scallop, flying C-pillar and rear taillamp treatments from the original (which were also used on the 4-door Charger concept from 2000). The exterior panels, especially the front fenders, are more curved and the body less slab sided that the previous generation. The only out of place feature on the car is the signature cross-hair grille, which reminds some of the Chrysler 300F, circa 1960.
Big changes are also in store for the cabin, which has a completely reworked interior that features a new thickly padded three-spoke steering wheel, upgraded accents and trim pieces, soft touch surfaces and revised instrument and control clusters.
While the body and interior have been greatly reworked, the LX mechanicals on which the car is based remain the same. The Charger will be offered in both rear- and all-wheel-drive variants and, initially, three trim levels, SE, Rallye and R/T. SE and Rallye models benefit from an all-new base engine, the 3.6-liter Pentastar world engine, a V-6 powerplant that will also be used on the new , which will debut later. The R/T will continue to offer the 5.7-liter V-8 Hemi engine and its fuel saving cylinder deactivation system that allows it to run on four-cylinders at highway speeds.
Also new for 2011 is an all-wheel-drive system that remains primarily in rear-drive, transferring torque to the front axle only when rear wheelslip is detected, which helps boost overall fuel economy.
Among the new features offered on the Charger are adaptive cruise control, forward collision warning, blind-spot monitoring and rear cross path detection, along with a rear backup camera.
The 2011 Dodge Charger is slated to go on sale before the end of the year. However, there's no word yet on the return of the SRT-8 version with its 6.2-liter Hemi to the lineup. Stay tuned.
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Public Colleges and Universities in Pennsylvania
2022 Top Public Colleges and Universities in Pennsylvania
Public colleges and universities are often the most affordable option for students pursuing higher education, but it's not just affordability that makes these institutions attractive. Public colleges and universities also rank highly among the best institutions in many states, Pennsylvania included.
Public institutions receive state and federal funding. Although they generally have larger class sizes than private institutions, they also tend to offer a wide variety of academic programs, diverse student bodies, and prestigious research opportunities.
2022 Best Public Colleges and Universities in Pennsylvania
Georgia51
Michigan47
Minnesota43
University of Pittsburgh-Pittsburgh Campus
University of Pittsburgh-Pittsburgh Campus, located in Pittsburgh, Pennsylvania, offers 488 programs for students. Degree-seekers enroll in top-ranked programs that offer a rigorous course of study. The school reports a 14-to-1 student-to-faculty ratio. At the institution, 78% of the students receive some form of financial aid. Students graduate from the school at a rate of 84%. Job seekers often benefit from hands-on experience, which makes them more competitive job candidates. The school offers experiential learning in the form of internships, research opportunities, and practicums. The admission rate is 64% for hopeful students. Some programs no longer require standardized tests for admission.
From its campus in Philadelphia, Pennsylvania, Temple University educates college students as a public institution. With both academic and technical programs, the school helps students reach their professional goals. Undergraduates complete lower-division and upper-division coursework to earn a bachelor's degree. The 120-credit bachelor's programs also include general education credits. Upper-division courses typically focus on advanced concepts within a major. Learners receive support in the form of tutoring and career services. Information on the school's cost per credit is unavailable. The accredited institution qualifies for federal student aid programs, including the Pell Grant. Temple University has been accredited by the Middle States Commission on Higher Education.
Slippery Rock University of Pennsylvania, which enrolls students in programs from its Slippery Rock, Pennsylvania campus. The college enrolls students in high-value programs and courses. The school offers academic and technical tracks to help students meet a variety of professional goals. Typically, it takes students two years to complete an associate degree, four years to earn a bachelor's degree, 1-2 years for a master's degree, or 3-7 years for a doctoral degree. Some programs may offer test-optional admission policies. Test-optional policies make it easier to enroll. Admission advisors can provide additional information on submitting an application. At the accredited institution, degree-seekers also qualify for financial aid to pay for school. The school holds accreditation from the Middle States Commission on Higher Education.
West Chester University of Pennsylvania
West Chester University of Pennsylvania, located in West Chester, Pennsylvania, offers 171 programs for degree-seekers. Degree-seekers benefit from rigorous programs that rank among the best in the nation. According to the institution, the student-to-faculty ratio stands at 20-to-1. According to the school, 85% of undergraduates receive some form of financial aid. The school reports a 75% graduation rate. The institution understands that hands-on experience helps job seekers enter the workforce. Learners benefit from internships, research opportunities, and other forms of service learning. The admission rate is 86% for hopeful students. Some programs operate with a test-optional policy for admissions.
Thaddeus Stevens College of Technology
A public institution, Thaddeus Stevens College of Technology enrolls students from its campus in Lancaster, Pennsylvania. Instructors bring expertise in their fields. Students who complete an academic or technical program enter the workforce or pursue a bachelor's degree. The institution's average cost per credit is unknown. At the accredited school, enrollees qualify for financial aid, including federal loans, scholarships, and grants. According to the institution, 90% of students receive aid and 60% receive loans. The public school reports a graduation rate of 55%. The admission rate for incoming students is 86%. Prospective students can contact the admissions department for more details about application requirements. Thaddeus Stevens College of Technology holds accreditation from the Middle States Commission on Higher Education.
From its Newtown, Pennsylvania campus, Bucks County Community College offers 110 program options for students. Students enjoy rigorous programs that rank among the best in the nation. The school maintains a student-to-faculty ratio of 15-to-1. At the institution, 51% of the students receive some form of financial aid. The school reports a graduation rate of 25%. The institution's commitment to experiential learning helps students enter the workforce. The school's admission rate is unknown at this time. Some programs provide a test-optional admission option. The admissions office provides more information about application requirements.
Butler County Community College
From its campus in Butler, Pennsylvania, Butler County Community College enrolls learners in 85 programs. Students enjoy rigorous programs that rank among the best in the nation. The school reports a student-to-faculty ratio of 11-to-1. A total of 84% of the students at this institution offest some of their education-related expenses with financial aid. The school reports a graduation rate of 29%. The institution understands that real-world experience helps job seekers enter the workforce. The admission rate is unknown at this time. Applicants may qualify for a waiver for standardized test scores. Prospective students can contact the admissions office for more information about applying.
Montgomery County Community College, located in Blue Bell, Pennsylvania, enrolls students as a public institution. Degree-seekers study with experts in many different fields. Students who complete a technical or academic program may enter the workforce. The amount students pay per credit on average is unknown. The accredited institution meets the requirements for federal financial aid programs, including the Pell Grant. At the institution, 62% of students receive financial aid and 25% take out loans. The public school reports a graduation rate of 25%. The rate of admission for the school is unknown. Prospective applicants can contact the admission department for more information about applying. Montgomery County Community College is accredited by the Middle States Commission on Higher Education, an independent accrediting body.
Located in Bloomsburg, Pennsylvania, Bloomsburg University of Pennsylvania grants college degrees as a public institution. With both academic and technical programs, the school helps students reach their educational goals. Learners pursuing a bachelor's degree complete lower- and upper-division coursework. Students also complete general education credits. Degree-seekers learn advanced concepts in their major during upper-division courses. Enrollees receive support in the form of tutoring and career services. The amount students pay per credit is currently unknown. The accredited institution qualifies for federal student aid programs, including the Pell Grant. Bloomsburg University of Pennsylvania has received accreditation from the Middle States Commission on Higher Education.
Millersville University of Pennsylvania, located in Millersville, Pennsylvania, enrolls students as a public institution. Instructors bring expertise in their fields. The school offers academic and technical programs that prepare graduates for the workforce or further study. The cost per credit is unknown. Students at the accredited institution qualify for federal financial aid, including grants and loans. A total of 91% of students receive financial aid and 60% take out loans at the school. The public school reports a 56% graduation rate. The admission rate is 85% for new students. Contact the admissions department for more details about application requirements. Millersville University of Pennsylvania holds accreditation from the Middle States Commission on Higher Education.
Pennsylvania Highlands Community College
Located in Pennsylvania, Pennsylvania Highlands Community College offers 40 programs for students. Students choose from rigorous, top-ranked programs at the school. The student-to-faculty ratio at the school is 18-to-1. According to the institution, 96% of enrollees receive some form of financial aid. The public institution reports a graduation rate of 32%. The institution's commitment to experiential learning helps graduates on the job market. The school's admission rate is unavailable. Some programs waive the test score requirement for qualified applicants. Applicants can reach out to the admission department to learn more about enrolling.
Pennsylvania College of Technology
A public institution located in Williamsport, Pennsylvania, Pennsylvania College of Technology offers multiple programs. The school offers programs that prepare graduates for careers and professional advancement. The programs offer an academically rigorous course of study at an affordable price. Multiple programs at the school appear in national rankings. The school's cost per credit is unknown. Degree-seekers at this accredited institution may qualify for federal student aid programs, including the Pell Grant. The school reports that students receive an average aid award of $7491, making the average tuition cost after aid $22973. Degree-seekers choose from academic and technical programs at the school. Based on their major, students take foundational courses, technical classes, and general education requirements. Pennsylvania College of Technology has received accreditation from the Middle States Commission on Higher Education, an independent accrediting body.
Westmoreland County Community College
Youngwood, PA
From its campus in Youngwood, Pennsylvania, Westmoreland County Community College offers programs as a public institution. With both academic and technical programs, the school helps learners reach their educational goals. The institution offers coursework that gives students the chance to gain relevant knowledge and skills. Some applicants qualify for a waiver for standardized test scores. Test-optional policies make it easier to apply. The school supports enrollees with tutoring and career services. The amount students pay per credit is unknown at this time. Learners at this accredited school also qualify for federal student aid programs, including the Pell Grant. Westmoreland County Community College holds accreditation from the Middle States Commission on Higher Education, an independent accrediting body.
University of Pittsburgh-Johnstown
University of Pittsburgh-Johnstown ranks as a top school from its campus in Johnstown, Pennsylvania. The institution's faculty brings expertise in multiple fields. The school offers academic and technical tracks to help students meet a variety of professional goals. Academic programs generally take anywhere from a few months to several years to complete depending on degree or certificate type. Some programs may operate with a test-optional policy for admissions. The waiver makes it simpler to enroll. The admissions department can help prospective students determine the next steps. Degree-seekers at the accredited institution also qualify for financial aid to cover costs. The school holds accreditation from the Middle States Commission on Higher Education, an independent accrediting body.
Northampton County Area Community College
Northampton County Area Community College, located in Bethlehem, Pennsylvania, enrolls students as a public institution. The school offers academic and technical programs to help learners reach their educational goals. The institution offers coursework that gives students the chance to gain relevant knowledge and skills. Depending on the program, applicants may need to submit test scores. Test-optional policies make it easier to apply. The school provides support such as tutoring and career services. Information on the school's cost per credit is unavailable. Learners at this accredited school also qualify for federal student aid programs, including the Pell Grant. The school is accredited by the Middle States Commission on Higher Education, an independent accrediting body.
Delaware County Community College
Located in Pennsylvania, Delaware County Community College offers 103 programs for students. Students benefit from rigorous programs that rank among the best in the nation. The school has a student-to-faculty ratio of 26-to-1. The institution reports that 71% of students receive some form of financial aid. Students in the school's programs graduate at a rate of 21%. The institution's commitment to experiential learning helps graduates become more competitive in the job market. The school's admission rate is unavailable. Applicants may qualify for a waiver for standardized test scores. Prospective students can contact the admission department for more information about applying.
Community College of Allegheny County
From its Pittsburgh, Pennsylvania campus, Community College of Allegheny County enrolls learners in 208 programs. Learners enroll in top-ranked programs that offer a rigorous course of study. The school has a student-to-faculty ratio of 18-to-1. A total of 74% of students receive some form of financial aid. The school reports a graduation rate of 16%. The institution understands that hands-on experience helps job seekers enter the workforce. The admission rate is unknown at this time. Some programs offer test-optional admission policies. Prospective students can contact an admission advisor to learn more about applying.
Community College of Beaver County
A public institution, Community College of Beaver County grants degrees from its campus in Monaca, Pennsylvania. The school offers academic and technical programs to help learners reach their educational goals. The institution's degree and certificate programs offer coursework that prepares learners for a career in their field. Depending on the program, applicants may need to submit standardized test scores. These policies make it easier to apply. The school supports learners with tutoring and career services. The school's cost per credit is unknown. Learners at the accredited school qualify for federal student aid programs. Community College of Beaver County holds accreditation from the Middle States Commission on Higher Education.
Edinboro University of Pennsylvania
From its campus in Edinboro, Pennsylvania, Edinboro University of Pennsylvania awards degrees as a public institution. Instructors draw on their expertise in diverse fields. The school offers academic and technical programs that prepare graduates for the workforce or further study. The school's average cost per credit is unknown. At the accredited institution, students qualify for financial aid, including federal loans, scholarships, and grants. The institution reports that 95% of students receive aid, and 69% receive loans. Students earn their bachelor's degree from the school at a rate of 43%. The admission rate is 85% for incoming students. Prospective applicants can contact an admission advisor to learn more about applying. Edinboro University of Pennsylvania holds accreditation from the Middle States Commission on Higher Education.
Reading Area Community College
From its campus in Reading, Pennsylvania, Reading Area Community College grants college degrees as a public institution. The school offers academic and technical programs to help learners reach their educational goals. Students complete coursework to prepare them for advanced roles. Some programs may offer test-optional admission policies. A test score waiver makes it easier to apply. Enrollees receive support in the form of tutoring and career services. The cost per credit is unknown. Learners attending the accredited school also qualify for federal financial aid programs, including the Pell Grant. Reading Area Community College is accredited by the Middle States Commission on Higher Education, an independent accrediting body.
Located in Shippensburg, Pennsylvania, Shippensburg University of Pennsylvania grants degrees as a public institution. With both academic and technical programs, the school helps students reach their educational goals. During a bachelor's degree, learners take lower-division and upper-division coursework. Undergraduates also complete general education credits. Degree-seekers study advanced concepts in their major during upper-division courses. Learners benefit from support services, which include tutoring and career counseling. The school's cost per credit is unknown. At the accredited institution, learners qualify for federal financial aid programs, such as the Pell Grant. Shippensburg University of Pennsylvania is accredited by the Middle States Commission on Higher Education, an independent accrediting body.
Cheyney University of Pennsylvania
Cheyney, PA
A public institution, Cheyney University of Pennsylvania grants degrees from its campus in Cheyney, Pennsylvania. The school offers academic and technical programs to help learners reach their educational goals. Students prepare for a successful career by completing degree- or certificate-specific coursework. Some programs offer a waiver for standardized test scores. Flexible admission score requirements make it easier to enroll. The school supports learners with tutoring and career services. The amount students pay per credit is currently unknown. Learners at the accredited school qualify for federal financial aid programs such as the Pell Grant. Cheyney University of Pennsylvania has been accredited by the Middle States Commission on Higher Education, an independent accrediting body.
Located in Philadelphia, Pennsylvania, Community College of Philadelphia offers multiple programs as a public institution. Students leave the school with credentials that prepare them for the workplace. Degree-seekers benefit from academically rigorous programs at an affordable price. The school boasts several programs that appear in national rankings. The amount students pay per credit on average is currently unknown. As an accredited institution, degree-seekers qualify for federal student aid programs, such as the Pell Grant. Current students receive an average aid award of $6076, lowering the average tuition cost after aid to $12712. The school offers both academic and technical programs. Depending on their program, students complete foundational courses, technical classes, and general education requirements. Community College of Philadelphia is accredited by the Middle States Commission on Higher Education.
Luzerne County Community College
Located in Nanticoke, Pennsylvania, Luzerne County Community College offers multiple programs as a public institution. Graduates leave the school prepared for the workforce. The institution offers academically rigorous programs at an affordable price. Students can enroll in nationally ranked programs. The amount students pay per credit on average is unknown. As an accredited institution, degree-seekers qualify for federal student aid programs, such as the Pell Grant. Students receive an average aid award of $5009, lowering the average tuition cost after aid to $8009. Learners choose from academic and technical majors at the school. The school offers foundational courses, technical classes, and general education courses in multiple majors. The school is accredited by the Middle States Commission on Higher Education.
Located in Schnecksville, Pennsylvania, Lehigh Carbon Community College enrolls students as a public institution. Enrollees take courses with experts in diverse disciplines. The college offers academic and technical programs that prepare graduates for the workforce or further study. The amount students pay per credit on average is unknown. Enrollees at the accredited institution qualify for federal student aid programs, including the Pell Grant. According to the institution, 86% of students receive aid and 54% receive loans. Students graduate from the school at a rate of 20%. The school's admission rate is currently unknown. Admissions advisors can provide more information about application requirements and start dates. The school is accredited by the Middle States Commission on Higher Education, an independent accrediting body.
A public institution located in California, Pennsylvania, California University of Pennsylvania offers multiple programs. Students earn an accredited degree that prepares them for the workforce. Learners benefit from academically rigorous programs at an affordable price. Several of the school's programs appear in national rankings. The cost per credit is unknown. As an accredited institution, degree-seekers qualify for federal student aid programs, such as the Pell Grant. The institution reports that students receive an average aid award of $ 6612, lowering the average tuition cost after aid to $ 19116. Learners choose from academic and technical programs. Students complete fundamentals courses, technical classes, and general education requirements. California University of Pennsylvania holds accreditation from the Middle States Commission on Higher Education.
From its campus in Clarion, Pennsylvania, Clarion University of Pennsylvania enrolls students as a public institution. With both academic and technical programs, the college helps students reach their educational goals. Learners complete lower-division and upper-division coursework to earn a bachelor's degree. Students also take general education coursework during their bachelor's degree. Upper-division credits typically focus on advanced concepts within a major. The school supports learners with tutoring and career services. The institution's average cost per credit is unknown. The accredited institution qualifies for federal student aid programs, including the Pell Grant. Clarion University of Pennsylvania has received accreditation from the Middle States Commission on Higher Education.
Kutztown University of Pennsylvania
From its campus in Kutztown, Pennsylvania, Kutztown University of Pennsylvania educates college students as a public institution. With both academic and technical programs, the institution helps students reach their professional goals. Bachelor's programs incorporate lower-division and upper-division requirements. Undergraduates also complete general education credits. Upper-division credits typically focus on advanced concepts within a major. The school provides support such as tutoring and career services. The amount students pay per credit on average is currently unknown. The accredited institution qualifies for federal student aid programs, including the Pell Grant. The school is accredited by the Middle States Commission on Higher Education.
From its campus in Pennsylvania, East Stroudsburg University of Pennsylvania enrolls students in 114 programs. The institution's rigorous programs rank among the best in the nation. The student-to-faculty ratio at the institution is 22-to-1. According to the school, 87% of undergraduates receive some form of financial aid. The school reports a graduation rate of 50%. The institution understands that real-world experience helps job seekers enter the workforce. The school incorporates internships, research opportunities, and service learning. Hopeful learners can expect admission rates of 91%. Some programs operate with a test-optional policy for admissions.
A public institution located in Harrisburg, Pennsylvania, Harrisburg Area Community College enrolls students in several programs. Graduates leave the school prepared for the workforce. Learners benefit from academically rigorous programs at an affordable price. Many of the school's degrees make national rankings. The amount students pay per credit is unknown at this time. As an accredited institution, degree-seekers qualify for federal student aid programs, such as the Pell Grant. Current students receive an average aid award of $3809, making the average tuition cost after aid $12315. Degree-seekers choose from academic and technical programs at the school. Students complete fundamentals courses, technical classes, and general education requirements depending on their program. The school is accredited by the Middle States Commission on Higher Education.
Why Choose a Public College or University in Pennsylvania?
Public colleges and universities in Pennsylvania offer access to a relatively affordable education and leading research centers and facilities.
The National Center for Education Statistics (NCES) College Navigator shows that Pennsylvania has 101 public colleges and universities. These include four-year and two-year institutions, as well as schools offering programs that can be completed in less than two years.
Four-year public colleges include The Pennsylvania State University (Penn State), the University of Pittsburgh, and Temple University.
Prospective students may think cost matters most when deciding on the right college — and it does. However, they must also weigh other factors, such as which schools offer courses in the field they want to study.
Penn State, for example, ranks 22nd for its research, according to the National Science Foundation rankings of Higher Education Research and Development research expenditures. The university boasted 12 fields of research that ranked in the top 10, including material science (which ranked first), psychology, sociology, and engineering.
The cost of attending private colleges in the Keystone State, such as the University of Pennsylvania, can be nearly three times as much as attending Pennsylvania's public schools.
Out-of-state students also typically pay more to attend college in Pennsylvania, especially since Pennsylvania does not maintain regional reciprocity agreements with other states. Online programs often offer flat tuition rates for students no matter where they live.
This guide details the most and least expensive public colleges and universities in Pennsylvania, what they cost, and how to choose the right college for you.
Pros and Cons of Attending a Public College or University in Pennsylvania
Cheaper tuition
Wide selection of majors, minors, and professional certificates
Larger campuses with plenty of activities, social clubs, programs, and events
Greater diversity in the classroom and on campus
Prominent faculty and state-of-the-art research facilities
Greater exposure to world views
Students at public college often still borrow money, which they must repay with interest when they graduate
Bigger public colleges may not offer the tight-knit communities some students seek
Students may feel overshadowed by the campus size and enrollment
Public schools may not attract as many international students
Admissions at leading public colleges can be competitive
Instructors may not provide personalized attention available at smaller, private colleges
Nonprofit vs. For-Profit Universities in Pennsylvania
There has been a lot of attention on for-profit colleges. Any profits these schools make is distributed among their shareholders. The shareholders' roles and the priority to make profits have been scrutinized.
For-profit schools are often viewed as providing a less rigorous education than nonprofit colleges. However, this is not always the case.
Pennsylvania has 106 private for-profit schools. Many provide specialized vocational training. These schools can offer flexible programs where students can quickly learn skills and get training in fields like cosmetology, automotive services, and aviation.
Nonprofit colleges, which include public and private schools, earn accreditation, a voluntary process that assures students that the school and its curriculum have been examined by an independent agency.
Nonprofit public universities and colleges in Pennsylvania get funding from the federal government as well as from tuition, donations, and endowments. Profits get reinvested into the schools. The funds are used to improve students' educational experience, pay instructors and professors, and fund research.
How Much Does It Cost to Attend a Public College or University in Pennsylvania?
According to NCES, in-state undergraduates at Pennsylvania public four-year colleges paid, on average, $15,656 for tuition and required fees, plus $11,838 for room and board, in 2019-2020. Private four-year colleges in Pennsylvania charged students an average of $42,812 for tuition and required fees during that same academic year.
Pennsylvania does not have regional reciprocity agreements with other states, which means nonresident students may pay double, if not more, for tuition.
NCES reports that Pennsylvania four-year public colleges charged out-of-state students $30,222 for tuition and required fees in 2019-2020. At two-year colleges in Pennsylvania, students paid $5,348 for in-state tuition and fees and $13,480 for out-of-state tuition and fees.
Colleges commonly add additional fees to pay for such things as campus activities, technology services, distance learning, and more.
Frequently Asked Questions About Public Colleges and Universities in Pennsylvania
How many public colleges and universities are there in Pennsylvania?
In Pennsylvania, there are 45 four-year and 26 two-year public colleges and universities, where students can pursue their educational goals.
These schools offer a wide variety of classes. So students can develop their current interests and form new ones that encourage them to engage with the world around them.
Some people may think public schools are not as academically challenging as private schools. This, however, is untrue.
Public colleges and universities are staffed with instructors and professors who are passionate about the subjects they teach and ignite this same enthusiasm to learn in their students. At any of the public institutions in Pennsylvania, students have the opportunity to thrive.
What is the most expensive public university in Pennsylvania?
The University of Pittsburgh ranks among the most expensive public colleges in Pennsylvania. For the 2021-2022 academic year, its undergraduate tuition rates were $19,092 for full-time, in-state students and $34,124 for out-of-state degree-seekers.
Nationwide, college tuition has increased over 170% over the last 40 years. To date, over 43 million Americans have $1.75 trillion in student loan debt.
What is the least expensive public university in Pennsylvania?
Bloomsburg University (BU) of Pennsylvania — with a full-time undergraduate tuition rate of $7,792 in 2022-2023 — ranks among the least expensive public universities in the state.
Other public universities in Pennsylvania with the least expensive tuition rates include California University of Pennsylvania, Lincoln University, and Millersville University.
Tuition at Pennsylvania's public universities fluctuates, and a student's residency status or their degree choice can make the final cost of college more expensive. Graduate students may also pay more for their education than undergraduate students.
What is the biggest public university in Pennsylvania?
Penn State is the biggest public university in Pennsylvania. Founded in 1855, the school has 24 campuses with 22,000 acres. Penn State boasts a total enrollment of 88,914 as of 2021 and more than 707,000 alumni worldwide. The enrollment includes 15,438 graduate students and 73,476 undergraduate students.
In 2021, Penn State received more than 168,000 applications.
Students choose from more than 160 bachelor's degree programs, as well as more than 90 associate degree and 190 graduate degree programs.
Penn State reported $993 million in research expenditures in 2021.
Is a public college or university right for me?
No one can truly answer this question but you. There are pros and cons to attending a public institution — what suits one student might not suit the next.
Public colleges typically cost less than private schools. Public colleges and universities provide a robust catalog of programs and research opportunities.
With a larger enrollment, the campus life at public colleges and universities in Pennsylvania can offer more social activities, volunteer and civic opportunities, clubs, and networking.
Private colleges also come with benefits such as prestige and generous scholarships and grants, thanks to funding from endowments.
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