Mobile Contingency Management for Smoking Cessation among Socioeconomically Disadvantaged Adults

针对社会经济弱势成年人戒烟的移动应急管理

• 批准号: 10380901
• 负责人: Darla Elizabeth Kendzor
• 金额: $ 59.85万
• 依托单位: UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-04-01 至 2026-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10380901
• 关键词: Abstinence; Adult; Annual Reports; Biochemical; Cancer Etiology; Car Phone; Carbon Monoxide; Cellular Phone; Cessation of life; Clinic; Data; Development; Equipment; Face; Family; Female; Friends; Future; Goals; Health Insurance; Health Services Accessibility; Healthcare; Healthcare Systems; Hospitals; Household; Incentives; Income; Individual; Intervention; Low income; Malignant neoplasm of lung; Mediating; Medicaid; Monitor; Motivation; Office Visits; Outcome; Ownership; Participant; Patient Self-Report; Persons; Pharmacology; Policies; Population; Prevalence; Process; Psychological reinforcement; Randomized; Randomized Controlled Trials; Research Personnel; Sampling; Schedule; Self Efficacy; Smoker; Smoking; Smoking Cessation Intervention; Socioeconomic Status; Survival Rate; System; Technology; Tobacco; Tobacco-Related Carcinoma; Travel; Video Recording; Visit; Withholding Treatment; Work; base; cancer health disparity; cigarette smoke; cigarette smoking; comparative cost effectiveness; contingency management; cost; cost effective; cost effectiveness; disease disparity; efficacy evaluation; experience; facial recognition software; financial incentive; follow-up; health disparity; innovation; low socioeconomic status; male; mortality; nicotine replacement; payment; portability; primary outcome; quitline; remote delivery; smoking abstinence; smoking cessation; smoking prevalence; socioeconomic disadvantage; standard care; telephone coaching; treatment group

Project Summary Although smoking prevalence has declined to 13.7% among U.S. adults, smoking rates are much higher among socioeconomically disadvantaged adults. Lung cancer, which is primarily caused by cigarette smoking, is the leading cause of cancer death in the U.S. Lung cancer mortality is far greater among those of lower socioeconomic status (SES) than their higher SES counterparts. Contingency management (CM), the tangible reinforcement of abstinence and other desired outcomes, is an effective approach to promoting smoking cessation in a variety of populations. The preliminary work of the investigators has indicated that offering small escalating financial incentives for smoking abstinence dramatically increases cessation rates among socioeconomically disadvantaged adults when incentives are included as an adjunct to clinic-based treatment. However, innovative approaches are needed for those who are unable or unwilling to attend office visits. Smartphone ownership is rapidly growing, even among low-income adults, and may offer a means of reaching and increasing treatment access among socioeconomically disadvantaged adults. The purpose of the proposed project is to evaluate an automated mobile phone-based CM approach that will allow socioeconomically disadvantaged individuals to remotely benefit from financial incentives for smoking cessation. The investigators have previously combined technologies including 1) portable carbon monoxide monitors that connect with mobile phones to remotely verify smoking abstinence, 2) facial recognition software to confirm participant identity during breath sample submissions, and 3) remote delivery of incentives automatically triggered by biochemical confirmation of self-reported abstinence. This automated CM approach will be evaluated in a randomized controlled trial that includes 532 socioeconomically disadvantaged males and females seeking smoking cessation treatment. Participants will be randomly assigned to either telephone counseling and nicotine replacement therapy (standard care [SC]) or SC plus a mobile financial incentives intervention (CM) for biochemically-confirmed abstinence. Participants will be followed for 26 weeks after a scheduled quit attempt. Biochemically-verified 7-day point prevalence abstinence at 26 weeks post-quit will be the primary outcome variable. Cost-effectiveness will be evaluated to inform policy-related decisions. Potential mobile CM treatment mechanisms, including self-efficacy, motivation, and treatment engagement, will be explored to optimize future versions of the intervention. Automated mobile CM offers a low-cost approach to smoking cessation that may be used in combination with existing telephone counseling and pharmacological interventions. If effective, this approach represents a critical step towards the widespread dissemination of CM treatment for smoking to practical settings (e.g. state quit lines, healthcare systems), with the goal of reducing tobacco-related disease and disparities.

项目摘要 尽管在美国成年人中吸烟率下降到13.7％，但吸烟率要高得多 在社会经济上处于不利地位的成年人中。肺癌主要是由吸烟引起的， 在美国肺癌死亡的主要原因是较低的肺癌死亡率的主要原因 社会经济地位（SES）比其更高的SES对应物。应急管理（CM），有形 加强禁欲和其他期望的结果，是促进吸烟的有效方法 停止各种人群。调查人员的初步工作表明，提供小型 升级用于戒烟的经济激励措施大大提高了停止率 当将激励措施作为基于诊所的治疗的辅助手段时，社会经济处境不利的成年人。 但是，对于那些无法或不愿参加办公室访问的人需要创新的方法。 智能手机所有权即使在低收入成年人中也正在迅速增长，并且可能提供一种触及的手段 并增加社会经济处境不利的成年人的治疗机会。目的 拟议的项目是评估一种基于手机的自动手机CM方法，该方法将允许 社会经济上处于弱势群体的个人，从吸烟中受益于经济激励措施 停止。研究人员以前已经合并了技术，包括1）便携式碳一氧化碳 与手机连接以远程验证戒烟的监控器，2）面部识别软件 在呼吸样本提交期间确认参与者身份，3）远程传递激励措施 自动对自我报告的禁欲的确认会自动触发。这种自动化的CM方法 将在一项随机对照试验中评估，其中包括532个社会经济处于不利的男性 和寻求戒烟治疗的女性。参与者将被随机分配到任何一种电话 咨询和尼古丁替代疗法（标准护理[SC]）或SC以及移动财务激励措施 干预措施（CM）对生化确认的禁欲。参与者将在A后26周内进行 计划退出尝试。生化验证的7天点戒酒率在QIT后26周将是 主要结果变量。成本效益将进行评估，以告知与政策相关的决定。潜在的 移动CM治疗机制，包括自我效能感，动机和治疗参与，将是 探索以优化干预的未来版本。自动移动CM提供了一种低成本的方法 可能与现有电话咨询和药理结合使用的戒烟 干预措施。如果有效，这种方法代表了CM广泛传播的关键步骤 吸烟到实际环境的治疗（例如，州戒烟线，医疗保健系统），目的是减少 与烟草有关的疾病和差异。