Contingency Management for Smoking Cessation in the Homeless

无家可归者戒烟应急管理

• 批准号: 8166519
• 负责人: Carla J Rash
• 金额: $ 21.68万
• 依托单位: UNIVERSITY OF CONNECTICUT SCH OF MED/DNT
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-08-01 至 2014-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8166519
• 关键词: Abbreviations; Abstinence; Behavior; Behavior Therapy; Biochemical; Carbon Monoxide; Cardiovascular system; Cause of Death; Censuses; Centers for Disease Control and Prevention (U.S.); Chronic; Cigarette; Communicable Diseases; Cotinine; Counseling; Disease; Exhibits; Feedback; Future; Gifts; Health; Health Services Accessibility; Healthcare; Homeless persons; Homelessness; Individual; Intake; Intervention; Laboratory Study; Lung diseases; Malignant Neoplasms; Medical; Meta-Analysis; Monitor; Nicotine; Outcome; Participant; Performance; Pilot Projects; Population; Predisposition; Prevalence; Prize; Psychological reinforcement; Public Health; Randomized; Reporting; Risk; Risk Behaviors; Sampling; Schedule; Services; Smoke; Smoker; Smoking; Smoking Behavior; Smoking Status; Substance Use Disorder; Time; Treatment outcome; Underserved Population; Urine; Visit; Withholding Treatment; burden of illness; cigarette smoking; contingency management; design; effective intervention; falls; follow-up; high risk; improved; indexing; interest; meetings; mortality; nicotine replacement; nutrition; smoking cessation; standard care; successful intervention; treatment effect

DESCRIPTION (provided by applicant): Smoking cessation services are an unmet need among the homeless, who smoke at rates more than 3 times the national estimate; successful interventions in this underserved population have the potential for improving individual and public health. Contingency management (CM) is a behavioral intervention with efficacy in a number of substance use disorder populations, including smokers. However, no known studies have evaluated the effect of CM in homeless smokers. We plan to examine smoking-related outcomes in homeless treatment-seeking smokers (N = 70) randomized to standard care smoking cessation (transdermal nicotine replacement therapy [NRT] + standard counseling + carbon monoxide [CO] monitoring) or standard care plus CM (NRT + standard counseling + CO monitoring + CM) conditions. Standard counseling and CO monitoring will occur for the first 4 weeks, with NRT use continuing through week 8. Participants in both conditions will meet with study staff up to twice daily on weekdays for biochemical verification of smoking status. Participants in the CM condition will have the opportunity to earn prizes for negative breath samples (CO d 4 ppm) up to twice daily on weekdays, with average expected reinforcement of about $408. Participants in the standard care condition will receive $2 gift cards for CO sample submissions up to twice daily on weekdays, noncontingent on smoking status. Follow-up assessments will be scheduled at 5, 9, 12, and 24 weeks post-quit date. We will use urine cotinine samples to verify smoking status at study intake and the 12- and 24-week follow-ups. CO breath samples will be collected at all visits. Primary treatment outcomes will include percent negative samples submitted, longest duration of abstinence achieved during treatment, and point prevalence rates of abstinence. We expect that participants randomized to CM will have better outcomes across these indices compared to those in standard care. Abbreviations: CM = Contingency management CO = Carbon monoxide CPD = Cigarettes per day LDA = Longest duration of continuous verified abstinence NRT = Nicotine replacement therapy PPM = Parts per million SC = Standard care PUBLIC HEALTH RELEVANCE: Smoking rates in the homeless population are more than 3 times the national smoking rate. This project evaluates the addition of contingency management to standard treatment to improve smoking outcomes in homeless smokers. Effective smoking cessation treatment for homeless smokers will benefit both the smokers' health and the public, on whom much of the homeless healthcare burden falls.

描述（由申请人提供）：戒烟服务是无家可归者的一个未满足的需求，他们的吸烟率是国家估计数的3倍以上;在这个服务不足的人群中成功的干预措施有可能改善个人和公共健康。应急管理（CM）是一种行为干预措施，在许多物质使用障碍人群中有效，包括吸烟者。然而，没有已知的研究评估了CM在无家可归的吸烟者中的作用。我们计划在无家可归的寻求治疗的吸烟者（N = 70）中检查吸烟相关的结果，这些吸烟者被随机分配到标准护理戒烟（经皮尼古丁替代疗法[NRT] +标准咨询+一氧化碳[CO]监测）或标准护理加CM（NRT +标准咨询+ CO监测+ CM）条件。前4周将进行标准咨询和CO监测，NRT使用持续至第8周。两种情况下的受试者将在工作日与研究工作人员会面，每天最多两次，以进行吸烟状态的生化验证。CM条件的参与者将有机会在工作日获得最多两次的负呼吸样本（CO d 4 ppm），平均预期加固约408美元。标准治疗条件下的受试者将收到2美元礼品卡，用于在工作日提交CO样本，最多每天两次，不取决于吸烟状态。随访评估将安排在戒烟后第5、9、12和24周进行。我们将使用尿液可替宁样本来验证研究摄入时以及12周和24周随访时的吸烟状态。将在所有访视时采集CO呼吸样本。主要治疗结局将包括提交的阴性样本百分比、治疗期间达到的最长禁欲持续时间和禁欲的点患病率。我们预计，与标准治疗组相比，随机分配至CM组的受试者在这些指标上的结局会更好。缩略语：CM =应急管理CO =一氧化碳CPD =每日吸烟量LDA =经验证的最长持续戒烟时间NRT =尼古丁替代疗法PPM =百万分之一SC =标准治疗 公共卫生相关性：无家可归人口的吸烟率是全国吸烟率的3倍多。该项目评估了在标准治疗中增加应急管理以改善无家可归吸烟者的吸烟结果。对无家可归的吸烟者进行有效的戒烟治疗将使吸烟者的健康和公众受益，无家可归者的医疗保健负担大部分福尔斯在公众身上。