A Mobile Just-in-Time Adaptive Intervention for Smoking Cessation: Pilot Randomized Controlled Trial
A Mobile Just-in-Time Adaptive Intervention for Smoking Cessation: Pilot Randomized Controlled Trial
复制标题
一种用于戒烟的移动即时适应性干预：试点随机对照试验
DOI：
10.2196/16907
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发表时间：
2020-03-09
影响因子：
7.4
通讯作者：
Businelle, Michael S.
中科院分区：
文献类型：
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作者：
Hebert, Emily T.;Ra, Chaelin K.;Businelle, Michael S.
背景：用于戒烟的智能手机应用程序可以提供易于获取、高度定制的强化干预措施，而成本仅为传统咨询的一小部分。尽管有数百个公开可用的戒烟应用程序，但很少有使用随机对照试验 (RCT) 设计进行实证评估的。智能治疗 (Smart-T2) 应用程序是一种及时的适应性干预措施，它使用生态瞬时评估 (EMA) 来评估即将戒烟的风险，并根据戒烟风险和报告的症状定制治疗信息。 目标：这项 3 臂试点随机对照试验旨在确定基于智能手机的自动戒烟干预 (Smart-T2) 相对于标准面对面戒烟诊所护理和国家癌症研究所免费吸烟的可行性和初步疗效戒烟应用程序，QuitGuide。方法：参加临床戒烟计划的成年吸烟者被随机分组并随访 13 周（戒烟前 1 周至戒烟后 12 周）。所有研究参与者都接受了尼古丁贴片和口香糖，并被要求每天在研究提供的智能手机上完成 EMA 5 次，持续 5 周。 Smart-T2 组的参与者在每次 EMA 完成后都会收到量身定制的治疗信息。 Smart-T2 和 QuitGuide 应用程序都提供按需戒烟治疗。结果：在 81 名参与者中，41 名 (50%) 是女性，55 名 (68%) 是白人。参与者的平均年龄为 49.6 岁，基线时每天吸 22.4 支香烟。共有 17% (14/81) 的参与者在戒烟后 12 周时获得生化证实的 7 天点流行率戒烟（Smart-T2：6/27, 22%，戒烟指南：4/27, 15%，常规护理：4/27, 15%），各组之间没有显着差异（P>.05）。 Smart-T2 组的参与者对该应用程序给予积极评价，大多数参与者同意他们可以依靠该应用程序来帮助他们戒烟，并认可该应用程序将帮助他们保持戒烟的信念，这些反应与常规护理组参与者给出的评级没有显着差异。结论：实时定制干预内容的动态智能手机应用程序可能会增加用户参与度和接触治疗相关材料。该试点随机对照试验的结果表明，基于智能手机的戒烟治疗可能能够提供与传统的面对面咨询类似的结果。
Background: Smartphone apps for smoking cessation could offer easily accessible, highly tailored, intensive interventions at a fraction of the cost of traditional counseling. Although there are hundreds of publicly available smoking cessation apps, few have been empirically evaluated using a randomized controlled trial (RCT) design. The Smart-Treatment (Smart-T2) app is a just-in-time adaptive intervention that uses ecological momentary assessments (EMAs) to assess the risk for imminent smoking lapse and tailors treatment messages based on the risk of lapse and reported symptoms.Objective: This 3-armed pilot RCT aimed to determine the feasibility and preliminary efficacy of an automated smartphone based smoking cessation intervention (Smart-T2) relative to standard in-person smoking cessation clinic care and the National Cancer Institute's free smoking cessation app, QuitGuide.Methods: Adult smokers who attended a clinic-based tobacco cessation program were randomized into groups and followed for 13 weeks (1 week prequitting through 12 weeks postquitting). All study participants received nicotine patches and gum and were asked to complete EMAs five times a day on study-provided smartphones for 5 weeks. Participants in the Smart-T2 group received tailored treatment messages after the completion of each EMA. Both Smart-T2 and QuitGuide apps offer on-demand smoking cessation treatment.Results: Of 81 participants, 41 (50%) were women and 55 (68%) were white. On average, participants were aged 49.6 years and smoked 22.4 cigarettes per day at baseline. A total of 17% (14/81) of participants were biochemically confirmed 7-day point prevalence abstinent at 12 weeks postquitting (Smart-T2: 6/27, 22%, QuitGuide: 4/27, 15%, and usual care: 4/27, 15%), with no significant differences across groups (P>.05). Participants in the Smart-T2 group rated the app positively, with most participants agreeing that they can rely on the app to help them quit smoking, and endorsed the belief that the app would help them stay quit, and these responses were not significantly different from the ratings given by participants in the usual care group.Conclusions: Dynamic smartphone apps that tailor intervention content in real time may increase user engagement and exposure to treatment-related materials. The results of this pilot RCT suggest that smartphone-based smoking cessation treatments may be capable of providing similar outcomes to traditional, in-person counseling.