Mindfulness-based Smoking Cessation Enhanced with Mobile Technology for Low-Income Smokers

项目摘要/摘要 吸烟是癌症的主要行为风险因素，是可预防的发病率和 美国社会经济地位低的成年人和某些种族/少数民族成员的死亡率 人群戒烟的可能性较小，因此经历了与烟草相关的严重癌症差异。那里 迫切需要改进循证戒烟干预措施，以更好地服务于这些人 人口。专注力训练大大提高了戒烟率和戒烟率。那里 是缺乏关于低社会地位者和种族/少数民族群体正念的研究，但这些干预措施确实 在这些人群中显示出戒烟的希望。但是，额外的会话间支持可能 这些吸烟者需要戒烟，他们每天都面临着戒烟的巨大障碍，而且戒烟的机会更少 获得戒烟资源。移动医疗技术(MHealth)可以为低 有吸烟者。例如，个性化的交互式mHealth消息可能会鼓励参与者使用 正念和其他戒烟技巧，在他们最需要的时候(例如，在 高压力或渴求的次数)，从而提高治疗效果。基于来自LOW的迭代反馈- SES，种族/民族不同的吸烟者，我们开发了一个短信程序(“iQuit Mindful”)作为一种 辅助以面对面正念为基础的戒烟治疗。我们的试点工作表明，iQuit 对低SES吸烟者(即23.1%的参与者)来说是可行的、可接受的，而且可能是最有效的 接受iQuit治疗的贫困家庭在治疗结束和1个月的随访中实现了戒烟， 而没有一个生活在贫困中的人在仅接受面对面治疗时戒烟)。在这项试点工作的基础上，我们将 整合参与者反馈，以进一步提高互动性和个性化，以便iQuit能够 更灵活地适应参与者不断变化的需求。本项目的具体目的是：1)检验疗效 由mHealth(IQuit Mindful)增强的基于正念的戒烟干预的研究，与在- 基于个人正念的成瘾治疗(MBAT)和日常护理；以及2)研究其机制 通过它，MBAT和iQuit使用密集的日常日记评估来认真地影响戒烟。 该项目旨在通过以下方式改善低SES、种族/民族多元化吸烟者的戒烟结果 用创新的mHealth方法补充现有的正念治疗。此外，我们的目标是 促进正念治疗作用机制的科学研究，这可以为 开发更有效和高效的治疗方法，以减少与烟草有关的癌症差异。

Project Summary/Abstract Tobacco use, a primary behavioral risk factor for cancer, is the leading cause of preventable morbidity and mortality in the U.S. Adults with low socioeconomic status (SES) and members of certain racial/ethnic minority groups are less likely to quit and consequently experience profound tobacco-related cancer disparities. There is an urgent need to improve upon evidence-based smoking cessation interventions to better serve these populations. Mindfulness training substantially increases rates of smoking cessation and lapse recovery. There is a dearth of research on mindfulness in low-SES and racial/ethnic minority groups, but these interventions do show promise for smoking cessation in these populations. However, additional between-session support may be needed for these smokers, who experience significant day-to-day barriers to quitting and have lower access to smoking cessation resources. Mobile health technology (mHealth) could provide vital 24/7 support for low- SES smokers. For example, personalized, interactive mHealth messages might encourage participants to use mindfulness and other smoking cessation techniques in the moments when they need them most (e.g., in times of high stress or craving), thus enhancing treatment effectiveness. Based on iterative feedback from low- SES, racially/ethnically diverse smokers, we developed a text messaging program (“iQuit Mindfully”) as an adjunct to in-person mindfulness-based smoking cessation treatment. Our pilot work demonstrates that iQuit Mindfully is feasible, acceptable, and perhaps most effective for low-SES smokers (i.e., 23.1% of participants living in poverty who received iQuit Mindfully achieved abstinence at end of treatment and 1-month follow-up, while none of those living in poverty quit in the in-person-only treatment). Building on this pilot work, we will incorporate participant feedback to further increase interactivity and personalization so that iQuit Mindfully can more flexibly adapt to participants’ changing needs. The specific aims of this project are to: 1) Test the efficacy of a mindfulness-based smoking cessation intervention enhanced by mHealth (iQuit Mindfully), compared to in- person mindfulness-based addiction treatment (MBAT) and usual care; and 2) Investigate the mechanisms through which MBAT and iQuit Mindfully impact smoking cessation using intensive daily diary assessment. This project aims to improve cessation outcomes for low-SES, racially/ethnically diverse smokers by supplementing existing mindfulness treatment with innovative mHealth methods. Furthermore, we aim to advance the scientific study of mechanisms of action of mindfulness treatment, which could inform the development of more efficacious and efficient treatments to reduce tobacco-related cancer disparities.