Re-Connect: Personalized, Non-Monetary Smartphone-based Rewards for Smoking Cessation

项目摘要 在美国，吸烟是可预防死亡的头号原因。约14%的美国 成年人现在吸烟，大约70%的吸烟者报告说想要戒烟。不幸的是，即使 在最好的戒烟干预措施中，复发是最有可能的结果。基于互联网的 应急管理(CM)是一种远程交付的循证干预，涉及 根据戒烟的客观证据提供财政奖励。基于互联网的CM 已经被证明是既可接受又高效的，所以研究努力现在集中在 通过探索节欲的非货币激励措施，这种干预是可扩展和可持续的。约81%的 美国成年人拥有一部智能手机，90%的人花在手机上的时间是使用应用程序 (应用程序)用于发送消息、玩手机游戏、社交网络、购物和阅读。给定 手机应用程序的广泛使用，以及它们的多样性，它们可能会成为个性化、低成本的理想选择 成本，非金钱的戒烟激励，将与广泛的受众在 移动CM干预的上下文。应用程序阻止程序阻止用户访问某些应用程序和 它们已经有了，而且需求量很大；然而，现有的应用程序拦截程序中没有一个是 旨在通过要求目标行为的客观证据(在这种情况下)来促进健康行为 戒烟)，然后再解锁该应用程序。目前提案的目的是(1)发展和(2) 评估Re-Connect，这是一个个性化的、基于智能手机应用程序屏蔽的CM干预，将限制 参与者访问高价值但非必要的手机应用程序(如社交媒体、购物、游戏)，直到 戒烟的客观证据已经得到证实。首先，我们将使用 动态系统开发，迭代测试，在每个阶段让寻求治疗的吸烟者参与的方法， 通过焦点小组和反馈会议进行可用性测试。第二，我们将随机分配治疗- 寻找吸烟者(N=50)：(1)戒烟应急(AC)，其中可以使用解锁应用程序的令牌 根据客观戒烟证据(CO&lt；6ppm)获得的收入，或(2)提交条件 (SC)可根据提交CO视频获得令牌，但不依赖于在6- 一个月的观察期。将评估重新连接的可行性和可接受性的初步结果 通过(A)登记，(B)使用期限，(C)停止使用的原因，和(D)参与者报告的可接受性。 初步疗效的初步结果将通过(E)每日CO阴性样本的百分比进行评估，以及 (F)经CO核实的两组之间自我报告吸烟状况的7天时点流行率。我们的团队 在移动CM干预、技术开发、焦点小组、单一案例方面拥有丰富的经验 设计、生物统计、人为因素测试和临床试验测试，使我们处于进行 拟议的概念验证开发和测试。

Project Summary Smoking is the number one cause of preventable death in the United States (U.S.). Approximately 14% of U.S. adults are current cigarette smokers, and about 7 out of 10 smokers report a desire to quit. Unfortunately, even among the best smoking cessation interventions, relapse is the most likely outcome. Internet-based contingency management (CM) is a remotely-delivered, evidence-based intervention that involves the provision of financial incentives contingent on objective evidence of smoking abstinence. Internet-based CM has been shown to be both acceptable and highly efficacious, so research efforts are now focused on making the intervention scalable and sustainable by exploring non-monetary incentives for abstinence. About 81% of U.S. adults own a smartphone and 90% of the time people spend on their phones involves using applications (apps) for sending messages, playing mobile games, social networking, shopping, and reading. Given the widespread use of mobile phone apps, and their variety, they may serve as an ideal personalized, low- cost, non-monetary incentive for smoking abstinence that would be relevant to a broad audience in the context of a mobile CM intervention. App blocking programs prevent users from accessing certain apps and they are already available and in high demand; however, none of the existing app-blocking programs are designed to promote health behavior by requiring objective evidence of the target behavior (in this case smoking abstinence) before unblocking the app. The aims of the current proposal are to (1) develop and (2) evaluate Re-Connect, a personalized, smartphone app-blocking-based CM intervention that would limit participants’ access to high-valued, but non-essential (e.g., social media, shopping, games), phone apps until objective evidence of smoking abstinence has been verified. First, we will develop and test Re-Connect using a dynamic systems development, iterative testing, approach involving treatment-seeking smokers at each stage, conducting usability tests via focus groups and feedback sessions. Second, we will randomly assign treatment- seeking smokers (N=50) to either: (1) abstinent contingent (AC) where tokens for unblocking apps can be earned contingent on objective evidence of smoking abstinence (CO < 6ppm), or (2) submission contingent (SC) where tokens can be earned contingent on submitting CO videos, but independent of quitting during a 6- month observation period. Primary outcomes of feasibility and acceptability of Re-Connect will be assessed via (a) enrollment, (b) duration of use, (c) reasons for discontinuation, and (d) participant-reported acceptability. Primary outcomes of preliminary efficacy will be assessed via (e) percent of negative daily CO samples, and (f) 7-day point prevalence of self-reported smoking status, verified by CO, between the two groups. Our team has extensive experience with mobile CM interventions, technology development, focus groups, single-case designs, biostatistics, human factors testing, and clinical trial testing, making us ideally positioned to carry out the proposed proof-of-concept development and testing.