Using Intensive Longitudinal Data Collected via Mobile Phone to Detect Imminent Lapse in Smokers Undergoing a Scheduled Quit Attempt.
Using Intensive Longitudinal Data Collected via Mobile Phone to Detect Imminent Lapse in Smokers Undergoing a Scheduled Quit Attempt.
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DOI：
10.2196/jmir.6307
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发表时间：
2016-10-17
影响因子：
7.4
通讯作者：
Vidrine DJ
中科院分区：
文献类型：
--
作者：
Businelle MS;Ma P;Kendzor DE;Frank SG;Wetter DW;Vidrine DJ
基于移动的手机的实时生态瞬时评估（EMA）已被用于记录健康风险行为，以及这些行为的前因，因为它们发生在接近真实的时间。本研究的目的是确定通过移动的电话收集的密集纵向数据是否可用于识别寻求戒烟治疗的社会经济弱势吸烟者中吸烟失效的迫在眉睫的风险。参与者被招募到一个随机对照戒烟试验在城市安全网医院戒烟诊所。所有参与者都在研究提供的移动的电话上完成了面对面的EMA。在2152个提示或自我发起的戒烟后EMA中收集了6个常见的失效风险变量（即，吸烟欲望，压力，最近饮酒，与吸烟者的互动，戒烟动机和香烟可用性），以确定失效风险因素的数量是否在即将失效时（即，4小时内）比失效时更大。各种策略被用来衡量变量的努力，以提高预测效用的失效风险估计。参与者（N=92）大多为女性（52/92，57%），少数民族（65/92，71%），51.9（SD 7.4）岁，每天吸烟18.0（SD 8.5）支。EMA数据显示，与未即将发生的失效相比，首次失效4小时内的冲动（P = 0.01），压力（P= 0.002），饮酒量（P <0.001），与吸烟者的互动（P<0.001）以及较低的戒烟动机（P= 0.03）。此外，在失效4小时内存在的失效风险因素总数（平均值2.43，SD 1.37）显著高于失效未临近期间存在的失效风险因素数量（平均值1.35，SD 1.04），P<0.001。总体而言，62%（32/52）的失效参与者至少完成了一项EMA，其中他们在首次失效后4小时内报告了≥3项失效风险因素。对失效风险变量进行不同的加权，可以改善风险估计（加权面积=0.76，未加权面积=0.72，P<0.004）。具体而言，所有失效的参与者中有80%（42/52）在首次失效后4小时内至少有一个失效风险评分高于截止值的EMA。吸烟失效风险的实时估计是可行的，并且可以为基于移动的手机的戒烟治疗的开发铺平道路，所述戒烟治疗基于特定失效触发的存在在真实的时间内自动定制治疗内容。识别失效风险并自动提供真实的定制信息或其他治疗成分的干预措施可以为无法获得其他更标准的戒烟治疗的个人提供有效，低成本和高度可传播的治疗。
Mobile phone‒based real-time ecological momentary assessments (EMAs) have been used to record health risk behaviors, and antecedents to those behaviors, as they occur in near real time. The objective of this study was to determine if intensive longitudinal data, collected via mobile phone, could be used to identify imminent risk for smoking lapse among socioeconomically disadvantaged smokers seeking smoking cessation treatment. Participants were recruited into a randomized controlled smoking cessation trial at an urban safety-net hospital tobacco cessation clinic. All participants completed in-person EMAs on mobile phones provided by the study. The presence of six commonly cited lapse risk variables (ie, urge to smoke, stress, recent alcohol consumption, interaction with someone smoking, cessation motivation, and cigarette availability) collected during 2152 prompted or self-initiated postcessation EMAs was examined to determine whether the number of lapse risk factors was greater when lapse was imminent (ie, within 4 hours) than when lapse was not imminent. Various strategies were used to weight variables in efforts to improve the predictive utility of the lapse risk estimator. Participants (N=92) were mostly female (52/92, 57%), minority (65/92, 71%), 51.9 (SD 7.4) years old, and smoked 18.0 (SD 8.5) cigarettes per day. EMA data indicated significantly higher urges (P=.01), stress (P=.002), alcohol consumption (P<.001), interaction with someone smoking (P<.001), and lower cessation motivation (P=.03) within 4 hours of the first lapse compared with EMAs collected when lapse was not imminent. Further, the total number of lapse risk factors present within 4 hours of lapse (mean 2.43, SD 1.37) was significantly higher than the number of lapse risk factors present during periods when lapse was not imminent (mean 1.35, SD 1.04), P<.001. Overall, 62% (32/52) of all participants who lapsed completed at least one EMA wherein they reported ≥3 lapse risk factors within 4 hours of their first lapse. Differentially weighting lapse risk variables resulted in an improved risk estimator (weighted area=0.76 vs unweighted area=0.72, P<.004). Specifically, 80% (42/52) of all participants who lapsed had at least one EMA with a lapse risk score above the cut-off within 4 hours of their first lapse. Real-time estimation of smoking lapse risk is feasible and may pave the way for development of mobile phone‒based smoking cessation treatments that automatically tailor treatment content in real time based on presence of specific lapse triggers. Interventions that identify risk for lapse and automatically deliver tailored messages or other treatment components in real time could offer effective, low cost, and highly disseminable treatments to individuals who do not have access to other more standard cessation treatments.
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