Comparing Population Cessation Services with Emphasis on Unmotivated Smokers

比较以无动机吸烟者为重点的人口戒烟服务

• 批准号: 8207415
• 负责人: James O Prochaska
• 金额: $ 9.42万
• 依托单位: UNIVERSITY OF RHODE ISLAND
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-01-15 至 2012-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8207415
• 关键词: Address; Aftercare; Alcohol abuse; Blue Cross; Collaborations; Combined Modality Therapy; Communication; Computers; Counseling; Drug Addiction; Drug abuse; Effectiveness; Health; Health Personnel; Health Services; Health Services Research; Healthcare Systems; Institutes; Intervention; Mediator of activation protein; Modeling; Motivation; National Institute of Drug Abuse; Nicotine Dependence; Outcome; Pharmaceutical Preparations; Population; Preparation; Prevention; Process; Provider; Quality of life; Randomized; Research; Research Personnel; Resources; Rhode Island; Sampling; Services; Smoker; Smoking; Staging; Treatment outcome; Withholding Treatment; Work; addiction; base; behavior change; comparative; comparative treatment; compare effectiveness; cost effective; cost effectiveness; ethnic minority population; follow-up; nicotine replacement; response; smoking cessation; therapy design; treatment effect; treatment strategy

DESCRIPTION (provided by applicant): This proposal is submitted in response to PA-07-119 (Health Services Research on the Prevention and Treatment of Drug and Alcohol Abuse) from NIDA and addresses major gaps in health services research for nicotine addiction treatments for entire populations of smokers and for the 80% who are not motivated to quit. Nicotine addiction is just like other drug addictions in terms of breaking the addiction cycle. This research will be done in collaboration with the Health and Wellness Institute founded for dissemination purposes by Blue Cross of Rhode Island which serves over 70% of the state. Health service researchers and providers differ on whether treatment emphasis should be on clinician-based counseling, biologically-based medications, computer-based tailored communications or a combination of these. There is a lack of comparative research on population treatments to compare effectiveness, cost-effectiveness and enhancement of quality of life. Such comparative research would provide health care systems and providers with evidence on how to best serve entire populations of smokers, especially unmotivated smokers who are seriously underserved. This research will compare the four most highly recommended treatments: 1. Motivation Enhancement Therapy (MET) plus NRT; 2. Reduction Therapy plus NRT; 3.Tailored communications based on the Transtheoretical Model (TTM), and 4. The combination of these treatments. A five group randomized comparative treatment design will compare MET, Reduction, TTM Tailored and combined treatments and assess multiple outcomes at 0, 6, 12, 18 and 24 months. The study will proactively screen the health care system population to identify a sample of 2,500 smokers, including 2,000 unmotivated smokers. Secondary aims will examine cessation outcome trajectories (No Treatment Effects, Stable Effects after treatment, Decreasing Effects or Increasing Effects), and potential mediators of how the treatments work. PUBLIC HEALTH RELEVANCE: If the treatment combining Motivation Enhancement, Reduction Counseling, Nicotine Replacement Therapy and Transtheoretical tailored interventions produces an increasing treatment trajectory, it will produce unprecedented impacts with unmotivated smokers specifically and population cessation generally. These recruitment and intervention strategies require limited resources from health care providers and could be readily disseminable to other health care systems for application with populations of smokers, especially unmotivated smokers who have been understudied and underserved.

描述（由申请人提供）：本提案是针对NIDA的PA-07-119（预防和治疗药物和酒精滥用的卫生服务研究）而提交的，并解决了针对整个吸烟者人群和80%没有戒烟动机的人的尼古丁成瘾治疗的卫生服务研究中的主要差距。就打破成瘾循环而言，尼古丁成瘾就像其他药物成瘾一样。这项研究将与卫生与健康研究所合作进行，该研究所是由罗德岛州蓝十字协会为传播目的而建立的，该协会为该州70%以上的人口提供服务。卫生服务研究人员和提供者在治疗重点应该是基于临床医生的咨询、基于生物的药物治疗、基于计算机的定制通信还是这些的结合上存在分歧。缺乏对人群治疗的比较研究，以比较有效性、成本效益和提高生活质量。这种比较研究将为卫生保健系统和提供者提供证据，说明如何最好地为所有吸烟者提供服务，特别是那些严重得不到服务的无动机吸烟者。这项研究将比较四种最受推荐的治疗方法：1。动机增强疗法（MET）加NRT；2. 减量治疗加NRT；3.3 .基于跨理论模型（TTM）的定制通信；这些疗法的结合。五组随机对照治疗设计将比较MET、Reduction、TTM定制治疗和联合治疗，并评估0、6、12、18和24个月的多项结果。这项研究将主动筛选卫生保健系统的人口，以确定2500名吸烟者的样本，其中包括2000名无动机吸烟者。次要目标将检查戒烟结果轨迹（无治疗效果，治疗后稳定效果，减少效果或增加效果），以及治疗如何起作用的潜在介质。公共卫生相关性：如果动机增强、减少咨询、尼古丁替代疗法和跨理论定制干预相结合的治疗产生越来越多的治疗轨迹，它将对无动机吸烟者产生前所未有的影响，特别是对人群戒烟。这些招募和干预策略需要卫生保健提供者提供有限的资源，并且可以很容易地传播到其他卫生保健系统，以应用于吸烟者人群，特别是研究不足和服务不足的无动机吸烟者。