Development of an Integrated mHealth App-Based Intervention to Support Smoking Cessation in People Living with HIV

开发基于移动医疗应用程序的综合干预措施以支持艾滋病毒感染者戒烟

• 批准号: 10408833
• 负责人: Bettina B. Hoeppner
• 金额: $ 21万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-01 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10408833
• 关键词: Abstinence; Acquired Immunodeficiency Syndrome; Adherence; Caring; Client satisfaction; Clinical; Clinical Practice Guideline; Collaborations; Community Health; Complement; Computers; Consultations; Data; Development; Disease; Equilibrium; Feedback; Funding; General Population; HIV; HIV Seropositivity; Health Technology; Highly Active Antiretroviral Therapy; Internet; Intervention; Interview; Life; Life Style; Measures; Medical; Meta-Analysis; Mobile Health Application; National Cancer Institute; Outcome; Participant; Patient Self-Report; Persons; Population; Prevalence; Primary Health Care; Process; Psychology; Public Health; Randomized; Randomized Controlled Trials; Reporting; Research Design; Sampling; Scientist; Self Efficacy; Smiling; Smoke; Smoker; Smoking; Smoking Cessation Intervention; Specific qualifier value; Structure; Study models; Technology; Testing; Text Messaging; Time; Training; Viral; Visit; Woman; Work; base; brief intervention; burden of illness; clinical care; design; experience; feasibility testing; flexibility; health goals; interest; mHealth; men; mortality; non-smoker; positive emotional state; primary care setting; programs; satisfaction; scale up; skills; smartphone Application; smoking cessation; smoking prevalence; social cognitive theory; software development; success; therapy development; treatment duration; user centered design; user-friendly

PROJECT SUMMARY / ABSTRACT The advent of highly active antiretroviral therapy (HAART) has greatly reduced mortality in persons living with HIV (PLWH), to the point where now lifestyle-related factors pose greater threat to long-term survival than HIV, chief among them smoking. Although interest in quitting smoking is high amongst PLWH, the prevalence of smoking among PLWH remains more than twice as high as that in the general population. Encouragingly, there have been successes in leveraging HIV primary care settings to engage PLWH smokers in smoking cessation efforts. Scaling up and expanding on this success has been difficult, however, as past evidence has indicated that interventions with more sessions produced stronger effects. High intensity face-to-face interventions are not readily scalable. Mobile health (mHealth) approaches, however, can provide continuous and as-needed support over longer periods of time, reducing the need for in-person treatment while providing prolonged support. To this end, and building on our previous work, we propose to develop an mHealth intervention that integrates (1) the “Smiling instead of Smoking” (SiS) app, a conceptually-grounded, iteratively developed smoking cessation smartphone app (M-PI Hoeppner), (2) a successful face-to- face smoking cessation treatment for SLH, called QUIT (M-PI O'Cleirigh), and (3) Life Steps, our efficacious brief intervention to promote adaptive engagement in HIV care. This integrated treatment will be informed and specified through the completion of the treatment development aims. We anticipate that it will combine initial face-to-face, SLH-focused treatment with SLH-adapted, real-time, temporally tailored smartphone app support over 8 weeks. Aim 1 is to build the integrated mHealth app intervention (SiS-H) based on feedback derived in user-centered design research with smokers living with HIV (SLH), consultation with HIV smoking cessation scientists and clinicians, and collaboration with our software development partner. Aim 2 is to conduct a proof-of-concept randomized controlled trial to test the feasibility, acceptability, and preliminary efficacy of SiS-H, while tracking HIV-specific outcomes. The app to be adapted is Version 3 of the SiS app, which is based on social cognitive theory, and implements clinical practice guidelines within a positive psychology framework. The proposed integrated treatment will emphasize protecting the experience of positive emotions among SLH as they navigate quitting smoking, and support increased self-efficacy through the complementing skills-based training of the QUIT and Life Steps components. The proposed project advances the critically important public health goal of making smoking cessation support more readily available to PLWH smokers. More pragmatically, data from this project could inform the design of a larger R01-funded RCT and the necessary regulatory strategy to advance towards approval of SiS-H as a prescription treatment that could well be sustainable in HIV primary care and other community health clinical settings.

项目摘要/摘要 高效抗逆转录病毒疗法（HAART）的出现大大降低了艾滋病毒感染者的死亡率。 艾滋病毒（PLWH），到了现在与生活方式有关的因素对长期生存的威胁比艾滋病毒更大的程度， 其中最主要的是吸烟。虽然艾滋病毒携带者对戒烟的兴趣很高， 艾滋病毒携带者和艾滋病患者的吸烟率仍然是一般人口的两倍多。令人鼓舞的是， 在利用艾滋病毒初级保健环境使艾滋病毒感染者吸烟方面取得了成功， 停止努力。然而，正如过去的证据所表明的那样， 表明，更多的会议干预产生更强的效果。高强度面对面 干预措施不容易扩大规模。然而，移动的健康（mHealth）方法可以提供连续的 和按需提供更长时间的支持，减少对亲自治疗的需求，同时提供 长期支持。为此，在我们以前工作的基础上，我们建议开发一个移动健康 干预，整合（1）“微笑而不是吸烟”（SiS）应用程序，一个概念接地， 迭代开发的戒烟智能手机应用程序（M-PI Hoeppner），（2）一个成功的面对面 面对SLH的戒烟治疗，称为退出（M-PI O 'Cleiigh），和（3）生活步骤，我们的 有效的简短干预，以促进艾滋病毒护理的适应性参与。这种综合治疗将 通过完成治疗开发目标来了解和指定。我们预计， 将联合收割机初始面对面、SLH聚焦治疗与SLH适应性、实时、临时定制治疗相结合 智能手机应用程序支持超过8周。目标1是建立综合移动健康应用程序干预（SiS-H） 基于以用户为中心的设计研究与艾滋病毒感染者（SLH）的反馈，咨询 与艾滋病毒戒烟科学家和临床医生合作，并与我们的软件开发合作伙伴合作。 目的2是进行一项概念验证随机对照试验，以测试其可行性、可接受性和 SiS-H的初步疗效，同时跟踪艾滋病毒特异性结果。要调整的应用程序是 SiS应用程序基于社会认知理论，并在积极的环境中实施临床实践指南。 心理学框架。拟议的综合治疗将强调保护的经验， SLH在戒烟过程中的积极情绪，并通过以下方式支持自我效能的提高： QUIT和Life Steps组成部分的补充技能培训。拟建项目 推进了使戒烟支持更容易获得的至关重要的公共卫生目标 吸烟者。更务实的是，来自该项目的数据可以为更大的R 01资助的设计提供信息。 RCT和必要的监管策略，以推进SiS-H作为处方治疗的批准 这在艾滋病毒初级保健和其他社区卫生临床环境中很可能是可持续的。