Enhancing Partner Support to Motivate Smokeless Tobacco Users to Quit Via the Web

描述(申请人提供)：大约1200万美国人习惯使用无烟烟草(ST)，尽管大多数人希望戒烟，但许多人缺乏资源。为了满足这一需求，研究人员最近完成了一项由美国国家癌症研究所资助的随机临床试验，以开发和评估ChewFree.com ST戒烟网站。我们招募了2523名ST用户，发现该网站非常有效，特别是对于那些最热衷于使用该网站的人。基于这一经验，我们认为，增加咀嚼者对该计划的参与度可以提高其有效性。探索提高项目参与度的途径之一是利用社会支持。ST的使用者(“咀嚼者”)绝大多数是男性，他们的妻子和家庭伴侣大多渴望他们戒烟。虽然人们对吸烟者的社会支持了解很多，但对吸烟者的社会支持知之甚少。在这项发展研究研究中，我们将测试在我们的网站上添加合作伙伴支持组件的可行性，以努力增加咀嚼者对该计划的注册和参与。目标：这项研究的主要目的是测试：1)通过印刷和广播媒体以及互联网招募女性支持者参加一个旨在帮助她们鼓励使用ST的男性伴侣参与戒烟计划的可行性。这项可行性研究将提供将登记的支持者比例的估计，以便在未来的随机试验中使用；2)合作伙伴支持部分对男性咀嚼者使用ChewFree.com自助ST戒烟计划的有效性。主要结果衡量标准将是ST用户对该计划的参与度，这是通过他登录该计划来衡量的。方法：我们计划使用我们的创新和成熟的方法招募944名女性，并将她们随机分配到两个条件之一：1)控制条件将模仿男性ST用户由其妻子或家庭伴侣向网络资源的自然主义推荐。2)在支持条件下，我们还会向妻子/伴侣提供如何支持咀嚼者戒烟的建议，并通过在线同行和专家论坛的形式为她提供自己的社会支持网络。在R21期间，我们将评估招募和干预男性咀嚼者的女性伴侣的可行性，并评估他们在信念、态度和行为方面的变化。措施：我们的主要结果将是咀嚼者在计划内对ChewFree网站的访问，这是通过不引人注目的网络日志来衡量的。在注册后6周和4.5个月，将通过邮寄调查来评估咀嚼者的戒烟相关行为以及支持、自我效能和关系动态的变化，以获得未来研究的效果大小。为了获得效果大小的估计，我们还将评估干预在设定戒烟日期、戒烟尝试和戒烟率方面的效果。好处：拟议的研究将：通过明确关注ST戒烟和男性使用者/女性支持者二元组的具体动态，增加社会支持文献；协助ST使用者的合作伙伴进行技能培训和社会支持，以及；增强我们有效的ST戒断计划的覆盖范围和有效性。争取和加强配偶或家庭伴侣的自然支持可能会增加无烟烟草使用者在戒烟计划中的参与度和成功率。公共卫生相关性：这项发展研究将在有效的基于网络的无烟烟草干预的背景下，测试与男性无烟烟草使用者的女性伴侣干预的相加效应的可行性。

DESCRIPTION (provided by applicant): Approximately 12 million Americans engage in the habitual use of smokeless tobacco (ST), and although most wish to quit, many lack resources. In order to meet this need, the investigators recently completed a randomized clinical trial, funded by the National Cancer Institute, to develop and evaluate the ChewFree.com ST cessation website. We enrolled 2,523 ST users and found the site to be effective, especially for those who were most engaged in using the web site. Based on this experience, we believe that increasing chewers' engagement with the program could increase its effectiveness. One avenue to explore for enhancing program engagement is the use of social support. The vast majority of ST users ("chewers") are male, and most of their wives and domestic partners are eager for them to quit. Although much is known about social support for smokers, little is known about social support for ST users. During this developmental research study, we will test the feasibility of adding a partner support component to our web site in an effort to increase chewers' enrollment in, and engagement with, the program. Objectives: The primary aims of this study are to test the: 1) feasibility of recruiting female supporters via print and broadcast media and the Internet to a program aimed at helping them encourage their male ST-using partners to engage in a quitting program. This feasibility study will provide estimates of proportions of supporters who will enroll, for use in a future randomized trial and; 2) effectiveness of a partner support component on male chewers' use of the ChewFree.com self-help ST cessation program. The primary outcome measure will be ST users' engagement with the program, as measured by his logging on to the program. Methods: We plan to use our innovative and proven methods to recruit 944 women, and randomize them to one of two conditions: 1) The Control Condition will emulate the naturalistic referral of a male ST user to web resources by his wife or domestic partner. 2) In the Support Condition, we will also give the wife/partner advice on how to support the chewer in quitting, and provide her with her own social support network in the form of online peer and expert forums. During this R21, we will assess the feasibility of recruiting and intervening with female partners of male chewers and with assessing changes in their beliefs, attitudes, and behavior. Measures: Our primary outcome will be chewers' access of the ChewFree web site within the program, as measured via unobtrusive web logs. Chewers' cessation-related behavior and changes in support, self- efficacy, and relationship dynamics will be assessed by mailed surveys at 6 weeks and 4.5 months post- enrollment to obtain effect sizes for future research. To obtain effect size estimates, we will also assess the effect of the intervention on setting a quit date, cessation attempts, and rates of tobacco cessation. Benefits: The proposed research will: add to the social support literature by focusing explicitly on ST cessation and the specific dynamics of the male-user/female-supporter dyad; assist partners of ST users with skills training and social support, and; enhance the reach and effectiveness of our effective ST cessation program. Enlisting and enhancing the natural support of a spouse or domestic partner may increase the engagement and success of smokeless tobacco users in cessation programs. PUBLIC HEALTH RELEVANCE: This developmental study will test the feasibility of the additive effects of intervening with the female partners of male smokeless tobacco users, in the context of an effective web-based smokeless tobacco intervention.