Web and Phone Intervention to Maintain Postpartum Tobacco Abstinence

通过网络和电话干预维持产后戒烟

• 批准号: 8278487
• 负责人: Brian G. Danaher
• 金额: $ 61.23万
• 依托单位: OREGON RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-06-09 至 2014-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8278487
• 关键词: Abstinence; Behavior; Child; Demographic Factors; Development; Feasibility Studies; Focus Groups; Health; Health Benefit; Health Services Accessibility; Health behavior change; Internet; Intervention; Knowledge; Lead; Maintenance; Measures; Mediator of activation protein; Methods; Moods; Morbidity - disease rate; Names; Online Systems; Outcome; Phase; Pilot Projects; Postpartum Period; Postpartum Women; Pregnancy; Preventive Intervention; Process; Public Health; Randomized; Recruitment Activity; Relapse; Relative (related person); Reporting; Research; Research Personnel; Risk; Role; Self Efficacy; Services; Smoking; Stress; Structure; Telephone; Testing; Time; Tobacco; Tobacco Use Cessation; Tobacco smoking; Tobacco use; Treatment Efficacy; Weight; Woman; Work; cost; depressive symptoms; design; disorder later incidence prevention; innovation; interest; mortality; non-smoker; novel; prevent; programs; quitline; smoking cessation; smoking relapse; therapy design; therapy development; tobacco abstinence; tobacco control; tool; treatment program; usability

DESCRIPTION (provided by applicant): Women who quit smoking for pregnancy are likely to resume tobacco smoking postpartum thereby placing themselves and their babies at risk. However, to date, tobacco interventions have not prevented sufficient numbers of women from relapsing postpartum. Thus, the postpartum period represents an important yet largely untapped opportunity to prevent the negative health consequences of smoking for women children. The proposed research builds on two threads of research by the investigators: 1) inquiry into the key role of weight concerns and mood in postpartum relapse prevention and 2) the use of enhanced Web-based interventions for health behavior change, generally, and tobacco cessation, specifically. Objectives: First, investigators propose to conduct formative work to develop an innovative, Enhanced Web+phone treatment designed to maintain tobacco abstinence postpartum. Then they will conduct a small randomized, controlled pilot feasibility study to assess the feasibility, acceptability, and initial efficacy of this novel, targeted, and tailored postpartum relapse prevention Web+phone intervention. Methods: In the first phase of this application, investigators propose to complete formative work involving postpartum women both in focus groups (n = 32) and in usability testing (n = 40) using an iterative treatment development process. In the second phase, investigators will conduct a pilot feasibility study in which 100 women who quit smoking for pregnancy and who want to remain nonsmokers postpartum will be randomly assigning to an Enhanced Web+phone intervention (n= 50) or a Basic Web Information Only control condition (n= 50). Women will be recruited by calls from research staff in late pregnancy using names and phone numbers provided by a commercial list service. Women will not be able to gain full access to the treatment program until after they have delivered. The proposed treatment program will be designed to be engaging, interactive, and tailored specifically to postpartum women. Measures: Assessment will focus on a) feasibility and acceptability of a Web-based tobacco abstinence maintenance program for postpartum women; b) efficacy of the intervention vs. the control in terms of tobacco use status; and c) exploratory analyses of putative underlying mechanisms (e.g., moderators, such as pre-pregnancy smoking rate, partner's tobacco use, and other demographic factors, and mediators, such as program usage, weight concerns, depressive symptoms, and perceived stress). Assessments will occur at baseline (via phone) and at three and six months postpartum (online). Non-responders will be called. Benefits: Postpartum women who maintain nonsmoking reduce risks of morbidity and mortality for themselves as well as protect the health of their baby. The development of a feasible and acceptable Web-based intervention to sustain tobacco abstinence could have substantial public health benefit because of its low cost and significant reach.

描述（由申请人提供）：怀孕期间戒烟的女性可能会在产后恢复吸烟，从而使自己和婴儿面临风险。然而，迄今为止，烟草干预措施尚未阻止足够数量的妇女产后复吸。因此，产后时期是预防吸烟对女婴健康造成负面影响的重要但尚未开发的机会。拟议的研究建立在研究人员的两条研究线索之上：1）调查体重问题和情绪在预防产后复发中的关键作用，2）使用增强的基于网络的干预措施来改变健康行为，特别是戒烟。目标：首先，研究人员建议开展形成性工作，开发一种创新的、增强型网络+电话治疗方法，旨在维持产后戒烟。然后，他们将进行一项小型随机、对照试点可行性研究，以评估这种新颖、有针对性、量身定制的产后复发预防网络+电话干预措施的可行性、可接受性和初步疗效。方法：在本申请的第一阶段，研究人员建议使用迭代治疗开发过程完成涉及产后妇女的焦点小组 (n = 32) 和可用性测试 (n = 40) 的形成性工作。在第二阶段，研究人员将进行一项试点可行性研究，其中 100 名因怀孕而戒烟并希望在产后保持不吸烟的女性将被随机分配到增强型网络+电话干预组 (n= 50) 或仅基本网络信息控制组 (n= 50)。研究人员将在怀孕后期通过商业名单服务提供的姓名和电话号码致电招募女性。妇女在分娩后才能完全获得治疗计划。拟议的治疗方案将旨在吸引人、互动，并专门针对产后妇女量身定制。措施：评估将侧重于 a) 针对产后妇女基于网络的戒烟维持计划的可行性和可接受性； b) 干预措施与控制措施在烟草使用状况方面的功效； c) 对假定的潜在机制的探索性分析（例如，调节因素，如孕前吸烟率、伴侣的烟草使用和其他人口因素，以及中介因素，如计划使用、体重问题、抑郁症状和感知压力）。评估将在基线（通过电话）和产后三个月和六个月（在线）进行。未响应者将被呼叫。好处：保持不吸烟的产后妇女可以降低自身发病和死亡的风险，并保护婴儿的健康。开发一种可行且可接受的基于网络的干预措施来维持戒烟可能会带来巨大的公共健康益处，因为其成本低且覆盖面广。