Behavioral Activation-Based Digital Smoking Cessation Intervention for Individuals With Depressive Symptoms: Randomized Clinical Trial.
Behavioral Activation-Based Digital Smoking Cessation Intervention for Individuals With Depressive Symptoms: Randomized Clinical Trial.
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DOI：
10.2196/49809
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发表时间：
2023-11-01
影响因子：
7.4
通讯作者：
中科院分区：
文献类型：
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抑郁症在吸烟的成年人中很常见。现有的针对抑郁症的戒烟干预措施覆盖面有限，不太可能改善这一庞大吸烟者亚群中的吸烟率。本研究旨在确定针对抑郁症的基于移动应用程序的干预措施与尼古丁替代疗法（NRT）的邮寄样本相结合，是否对治疗抑郁症和促进戒烟有效。在美国进行了一项2组全国远程随机临床试验。纳入吸烟的抑郁症状升高的成人（N=150）（患者健康问卷-8≥10）。手机应用“Goal2Quit”提供了基于抑郁症行为激活治疗的治疗抑郁症和戒烟的行为策略。受试者还接受了为期2周的联合NRT治疗。与往常一样，参与者收到了一本戒烟自助手册，这本小册子不是为抑郁症量身定做的。主要终点包括Goal2Quit的可用性，12周内抑郁症的变化（Beck抑郁量表- ii），戒烟包括每天吸烟量的减少，24小时戒烟尝试的发生率，浮动戒烟和7天点流行戒烟（PPA）。在2020年6月25日至2022年2月23日期间，共有150名参与者入组，其中80名为女性（53.3%），平均年龄为38.4 （SD 10.3）岁。在基线时，参与者平均报告中度抑郁症状，平均每天吸烟14.7支（SD 7.5）。目标2quit的可用性很强，在系统可用性量表上的平均可用性评分为78.5（标准差为16.9），70%的评分高于高于平均可用性的临界值≥68。应用用户留存数据在试验注册后立即呈现强劲势头，随后数周呈下降趋势。与常规治疗相比，接受Goal2Quit和NRT样本的患者在试验期间报告的平均抑郁症状较低（平均差3.72，差1.37点；P= 0.01）。在各个时间点上，所有的戒烟结果都有利于目标戒烟。在戒烟方面，Goal2Quit参与者报告在第4周（11%对0%，P= 0.02）、第8周（7天PPA: 12%对0%，P= 0.02）和第12周（16%对2%，P= 0.02）的7天PPA发生率显著较高。针对抑郁症量身定制的移动应用程序干预与NRT样本相结合，对抑郁症治疗和戒烟有效。研究结果支持这种干预方法的效用，以解决目前未满足的公共卫生治疗需求，即定制的、可扩展的抑郁症特定戒烟治疗。ClinicalTrials.gov NCT03837379;https://clinicaltrials.gov/ct2/show/NCT03837379
Depression is common among adults who smoke cigarettes. Existing depression-specific cessation interventions have limited reach and are unlikely to improve smoking prevalence rates among this large subgroup of smokers. This study aimed to determine whether a mobile app–based intervention tailored for depression paired with a mailed sample of nicotine replacement therapy (NRT) is efficacious for treating depression and promoting smoking cessation. A 2-arm nationwide remote randomized clinical trial was conducted in the United States. Adults (N=150) with elevated depressive symptoms (Patient Health Questionnaire-8≥10) who smoked were enrolled. The mobile app (“Goal2Quit”) provided behavioral strategies for treating depression and quitting smoking based on Behavioral Activation Treatment for Depression. Goal2Quit participants also received a 2-week sample of combination NRT. Treatment as usual participants received a self-help booklet for quitting smoking that was not tailored for depression. Primary end points included Goal2Quit usability, change in depression (Beck Depression Inventory-II) across 12 weeks, and smoking cessation including reduction in cigarettes per day, incidence of 24-hour quit attempts, floating abstinence, and 7-day point prevalence abstinence (PPA). In total, 150 participants were enrolled between June 25, 2020, and February 23, 2022, of which 80 were female (53.3%) and the mean age was 38.4 (SD 10.3) years. At baseline, participants on average reported moderate depressive symptoms and smoked a mean of 14.7 (SD 7.5) cigarettes per day. Goal2Quit usability was strong with a mean usability rating on the System Usability Scale of 78.5 (SD 16.9), with 70% scoring above the ≥68 cutoff for above-average usability. Retention data for app use were generally strong immediately following trial enrollment and declined in subsequent weeks. Those who received Goal2Quit and the NRT sample reported lower mean depressive symptoms over the trial duration as compared to treatment as usual (difference of mean 3.72, SE 1.37 points less; P=.01). Across time points, all cessation outcomes favored Goal2Quit. Regarding abstinence, Goal2Quit participants reported significantly higher rates of 7-day PPA at weeks 4 (11% vs 0%; P=.02), 8 (7-day PPA: 12% vs 0%; P=.02), and 12 (16% vs 2%; P=.02). A mobile app intervention tailored for depression paired with a sample of NRT was effective for depression treatment and smoking cessation. Findings support the utility of this intervention approach for addressing the currently unmet public health treatment need for tailored, scalable depression-specific cessation treatments. ClinicalTrials.gov NCT03837379; https://clinicaltrials.gov/ct2/show/NCT03837379
影响因子：
4.7
作者：
Marsch, Lisa A.;Chen, Ching-Hua;Adams, Sara R.;Asyyed, Asma;Does, Monique B.;Hassanpour, Saeed;Hichborn, Emily;Jackson-Morris, Melanie;Jacobson, Nicholas C.;Jones, Heather K.;Kotz, David;Lambert-Harris, Chantal A.;Li, Zhiguo;McLeman, Bethany;Mishra, Varun;Stanger, Catherine;Subramaniam, Geetha;Wu, Weiyi;Campbell, Cynthia I.
通讯作者：
Campbell, Cynthia I.
影响因子：
7.4
作者：
Dahne, Jennifer;Player, Marty S.;Strange, Charlie;Carpenter, Matthew J.;Ford, Dee W.;King, Kathryn;Miller, Sarah;Kruis, Ryan;Hawes, Elizabeth;Hidalgo, Johanna E.;Diaz, Vanessa A.
通讯作者：
Diaz, Vanessa A.