Game-based contingency management for smoking cessation

基于游戏的戒烟应急管理

• 批准号: 8285143
• 负责人: BETHANY R RAIFF
• 金额: $ 1.17万
• 依托单位: NATIONAL DEVELOPMENT AND RESEARCH INSTITUTES, INC.
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-08-15 至 2012-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8285143
• 关键词: Abstinence; Alcohol abuse; Asthma; Behavior; Carbon Monoxide; Chronic Disease; Clinical Trials; Control Groups; Development; Diabetes Mellitus; Drug abuse; Drug usage; Evidence based intervention; Exhalation; Feedback; Gifts; Goals; Gold; Health; Incentives; Individual; Internet; Intervention; Monitor; Morbidity - disease rate; Names; Outcome; Outcome Measure; Participant; Patient Self-Report; Persons; Pilot Projects; Play; Process; Property; Public Health; Randomized; Reporting; Research; Rewards; Sampling; Smoker; Smoking; Smoking Cessation Intervention; Smoking Status; Social Reinforcement; Surveys; Testing; Time; Training; Treatment Cost; Video Games; Video Recording; alcohol and other drug; base; cigarette smoking; contingency management; cost; effective intervention; evidence base; improved; innovation; medical complication; medication compliance; meetings; member; mortality; prevent; primary outcome; smoking cessation; smoking intervention; social; standard measure; success; virtual

DESCRIPTION (provided by applicant): Cigarette smoking remains the number one cause of preventable morbidity and mortality in the U.S. A number of barriers have been noted that prevent access to smoking cessation interventions, such as lack of clinician training, the time commitment required to implement treatments, and the costs associated with treatment. Thus, it is critically important that more effective interventions be developed, and be made accessible at a relatively low cost, to smokers. We recently developed an Internet-based Contingency Management (CM) intervention, where participants submit web-camera recorded videos as they exhale into a CO monitor, and they earn money for abstinence. Although the costs associated with providing monetary incentives contingent on smoking abstinence are likely to be less than the costs associated with medical complications caused by smoking, the cost of incentives is often cited as a barrier to CM. Thus, the goals of the present proposal are to markedly decrease costs and increase sustainability of this highly accessible Internet-based CM for smoking cessation. Using an iterative development process with the help of a team of experts, a social strategy video game intended to be fun and engaging will be developed for Facebook ("Quitters, Incorporated"). Treatment- seeking smokers will be able to earn incentives contingent on meeting web-camera verified CO values consistent with smoking abstinence. Three powerful, evidence-based incentives will be harnessed in this CM intervention. The incentives will consist of: (1) individual contingencies that can be used to improve game play, (2) social contingencies, such as positive feedback and virtual rewards, that can be given to other players to acknowledge their success with abstinence and improve their game play, and (3) group contingencies that will require all members of a group to meet abstinence goals in order to unlock access to certain game features. After game development, we will assess the feasibility, acceptability, appeal, and preliminary efficacy of video- game-based CM for smoking cessation. A 7-week pilot study will involve randomly assigning participants (N=100) to either: (1) abstinent contingent, where incentives will be delivered contingent on quitting smoking, or (2) submission contingent, where incentives will be delivered contingent on submitting videos, but independent of quitting smoking. The outcomes of the pilot study will impact future research in the development of video-game-based CM interventions for smoking, as well as for alcohol and other drug use, and medication compliance in diabetes, asthma, and other conditions. Game-based CM will promote widespread access to this innovative, fun, sustainable intervention at a relatively low cost (the game will be available to play for free), thereby offering the potential t have a substantial public health impact. PUBLIC HEALTH RELEVANCE: We propose to develop and evaluate an online video-game-based smoking cessation intervention that will overcome barriers to treatment such as cost and sustainability. This video- game will be the first of its kind, based on an evidence-based intervention shown to promote smoking abstinence. The findings from this research will be of great public health significance because of the unprecedented reach and relatively low cost, as well as the potential for similar interventions to be developed for other health problems, such as alcohol or drug abuse and medication adherence for chronic illnesses.

说明(申请人提供)：在美国，吸烟仍然是可预防的发病率和死亡率的头号原因。人们注意到，许多障碍阻碍了获得戒烟干预措施，例如缺乏临床医生培训，实施治疗所需的时间承诺，以及与治疗相关的成本。因此，至关重要的是制定更有效的干预措施，并以相对较低的成本向吸烟者提供。我们最近开发了一种基于互联网的应急管理(CM)干预，参与者在呼气时向CO监视器提交网络摄像机记录的视频，他们通过禁欲赚钱。虽然以戒烟为条件提供金钱奖励的相关成本可能比吸烟引起的医疗并发症相关的成本要低，但激励的成本经常被认为是CM的障碍。因此，本提案的目标是显著降低成本，并增加这一高度可访问的基于互联网的戒烟CM的可持续性。在专家团队的帮助下，使用迭代开发过程，将为Facebook开发一款旨在有趣和吸引人的社交策略视频游戏。寻求治疗的吸烟者将能够获得奖励，条件是达到网络摄像头验证的与戒烟一致的CO值。三个强有力的、以证据为基础的激励将被利用在这一CM干预中。这些激励措施包括：(1)可用于改进游戏体验的个人突发事件；(2)可给予其他玩家以承认他们成功禁欲并改善游戏体验的社会突发事件，如积极反馈和虚拟奖励；以及(3)群体突发事件，即要求一个群体的所有成员都达到戒酒目标，才能获得某些游戏功能。在游戏开发后，我们将评估基于视频游戏的CM戒烟的可行性、可接受性、吸引力和初步效果。一项为期7周的试点研究将把参与者(N=100)随机分配到以下两组中：(1)戒烟小组，根据戒烟情况给予奖励；或(2)提交小组，根据提交视频的情况给予奖励，但与戒烟无关。试点研究的结果将影响未来开发基于视频游戏的CM干预措施的研究，这些干预措施适用于吸烟、酒精和其他药物使用，以及糖尿病、哮喘和其他疾病的用药依从性。基于游戏的CM将以相对较低的成本促进这种创新、有趣、可持续的干预措施的广泛使用(游戏将免费提供)，从而提供潜在的重大公共卫生影响。 与公共健康相关：我们建议开发和评估一种基于在线视频游戏的戒烟干预措施，该干预措施将克服治疗方面的障碍，如成本和可持续性。这款电子游戏将是此类游戏中的第一款，它基于一项旨在促进戒烟的循证干预。这项研究的结果将具有重大的公共卫生意义，因为这项研究的覆盖范围史无前例，成本相对较低，而且有可能为其他健康问题开发类似的干预措施，如酗酒或药物滥用以及慢性病的用药依从性。