Delivery of a Smoking Cessation Induction Intervention Via Virtual Reality Headset During a Dental Cleaning

普通人群的吸烟率为15.5%，但在低收入人群中超过30% 受教育程度低。这些吸烟者主动寻求戒烟咨询的可能性更小，也更少 可能曾经使用过循证治疗(EBTS、咨询和药物)来戒烟。 因此，主动接触吸烟者是很重要的。研究支持吸烟的有效性 牙科环境中的戒烟咨询。然而，一致实施的障碍包括提供商缺乏 为没有戒烟动机的吸烟者提供时间、培训和经验的咨询。使用技术可以 提供一种既经济又省时的牙科戒烟方法 设置具有高度的处理保真度。因为有效的戒烟方案已经存在， 需要创新来推动吸烟者参与EBTS。我们的初步研究开发并测试了一段视频- 通过虚拟现实(VR)耳机提供的基于戒烟诱导干预的患者 正在进行牙齿清洁。城市牙科诊所的患者(n=23)戴着VR耳机观看10- 清洁牙齿过程中的分钟戒烟诱导视频(由于潜在的原因，未在VR中拍摄 干扰临床护理)。我们展示了患者的满意度、可行性、对调解人的影响，以及没有 对临床护理的干扰。一个月后，5/23患者报告戒烟，14/23患者报告戒烟 退出尝试。UH3阶段3随机疗效试验的主要目的是测试上述 干预增加了EBTS的利用率(Quitline、基于临床的程序、NCI短信程序、NRT或 其他戒烟药物)在预约后7个月内。参与者(n=376)将是吸烟者 计划在一家城市牙科诊所清洁牙齿，主要服务于服务不足的患者。 参与者将随机接受VR干预，该干预包括：1)基于视频的干预 通过VR耳机清洁牙齿，2)关于EBTS的小册子，以及3)一个月的短信 激发EBTS的参与度；或控制组，由观看放松控制视频组成 在清洁牙齿和接受治疗期间通过VR耳机进行的技术(以保持提供者的遮盖) 与VR组相同的EBT手册。两个小组都将收到每周一次的短信评估 在牙科预约后一个月评估调解员。我们将客观地衡量Quitline的利用率， 短信程序，以及基于诊所的程序。次要结果是戒烟的治疗效果 尝试，生化验证的禁欲和戒烟动机。我们还将评估主持人。 评估将在基线上进行，在任命后一个月内每周进行一次(通过文本)，在任命后一个月内进行- 任命，3个月和6个月后。在UH3之前，UG3阶段将涉及最终确定 干预、可用性研究、提供商访谈、创建研究之间的无缝过渡 干预和EBTS、措施的最终确定、对调解人的影响以及满意度/可接受性数据。

The prevalence of smoking is 15.5% in the general population, but exceeds 30% among those with low income and low education. These smokers are less likely to proactively seek smoking cessation counseling, and less likely to have ever used evidenced-based treatment (EBTs, counseling and medications) for quitting smoking. Therefore, it is important to proactively reach smokers. Research supports the effectiveness of smoking cessation counseling in dental settings. However, barriers to consistent implementation include provider lack of time, training, and experience counseling smokers who are unmotivated to quit. Using technology could provide a cost-effective and time-efficient way of delivering evidenced-based smoking cessation in dental settings with a high degree of treatment fidelity. Because effective cessation programs already exist, innovations are needed to drive smokers to engage with EBTs. Our pilot study developed and tested a video- based smoking cessation induction intervention delivered through a Virtual Reality (VR) headset, while patients were undergoing teeth cleaning. Patients in an urban dental clinic (n=23) wore the VR headset to watch a 10- minute smoking cessation induction video during their teeth cleaning (not filmed in VR due to potential interference with clinical care). We demonstrated patient satisfaction, feasibility, impact on mediators, and no interference with clinical care. One month later, 5/23 patients reported smoking cessation, and 14/23 reported quit attempts. The primary aim of the UH3 Stage 3 randomized efficacy trial is to test whether the above intervention increases utilization of EBTs (Quitline, Clinic-based programs, NCI text message program, NRT or other smoking cessation medication) within 7-months post-appointment. Participants (n=376) will be smokers scheduled for a teeth cleaning at an urban dental clinic predominately serving underserved patients. Participants will be randomized to either the VR intervention, which consists of: 1) the video-based intervention via VR headset during their teeth cleaning, 2) brochure about EBTs, and 3) one month of text messages to motivate engagement with EBTs; or Control group, which consists of watching a control video on relaxation techniques through the VR headset (to maintain provider masking) during the teeth cleaning and receipt of the same EBT brochure as the VR group. Both groups will receive weekly text message assessments for one month after the dental appointment to assess mediators. We will objectively measure utilization of the Quitline, the text message programs, and clinic based programs. Secondary outcomes are treatment effects on quit attempts, biochemically verified abstinence, and motivation to quit. We will also assess moderators. Assessments will occur at baseline, weekly for one month after the appointment (via text), one month post- appointment, and 3 and 6 months later. Prior to UH3, the UG3 phase will involve finalization of the intervention, a usability study, provider interviews, creation of a seamless transition between the study intervention and EBTs, finalization of measures, impact on mediators, and satisfaction/acceptability data.