Quit IT: Development of a Web-based 3D Coping Skills Game to Increase Self-Effic

描述(由申请人提供)：烟草使用仍然是导致过早死亡和癌症的最可预防的单一原因。1基于十多年治疗烟草依赖的临床和研究经验，我们建议通过一种新的学术-小型电脑游戏企业合作伙伴关系来解决这一问题，该合作伙伴将开发一种新型的电子健康戒烟和预防复发产品。戒烟尝试后再次吸烟仍然是一个重大的公共卫生问题，在质量调整的生命年中成本很高。越来越多的证据表明，持续的练习或行为彩排可以帮助吸烟者有效地管理吸烟线索，而且吸烟线索可以通过与计算机的交互虚拟地触发。2因此，我们建议创建一种3D游戏干预，旨在帮助吸烟者彩排有效的策略和提高管理吸烟触发因素的自我效能。鉴于我们对这一概念的初步工作，我们的综合专业知识，以及这一概念的商业化潜力，我们正在寻求快速提交。在第一阶段，我们计划将我们在虚拟世界第二人生中开发的应对技能模拟转化为一个可访问的、结构化的游戏环境，其中包含旨在促进戒烟的成熟互动游戏所必需的元素。使用系统的反馈协议，我们将使用从纪念斯隆-凯特琳戒烟计划招募的患者志愿者和在治疗烟草依赖方面具有专业知识的行为科学研究人员来完善游戏的可用性、相关性和实用性。在第二阶段，我们将整合阿尔法测试数据和应对技能游戏的完整开发，包括3D环境和游戏头像、应对技能的游戏设计和脚本、患者的反馈和奖励以及数据收集能力。然后，使用在纪念斯隆-凯特琳癌症中心进行的随机试验设计，我们将测试这款游戏在提高应对自我效能和减少住院癌症患者复发吸烟方面的潜力。虽然新诊断为烟草相关癌症的患者的戒烟率通常很高，但许多人在无烟医院环境出院后不久仍继续吸烟或恢复吸烟。3-5尽管经常报告有很高的戒烟动机和持续吸烟的严重后果，但癌症患者在住院后再次吸烟的风险很高，并且是测试我们游戏潜力的理想人群。我们将使用两组设计(日常护理+吸烟提示应对技能游戏与仅日常护理)随机选择190名患者，并在住院后1、3和6个月收集自我效能和烟草使用数据。如果我们的新应对技能游戏显示出加强烟草依赖治疗的有效性，那么拟议的研究可能会产生很大的影响。这一概念对住院吸烟者的广泛目标受众非常有市场，并可能提供许多好处，作为目前戒烟干预的补充。

DESCRIPTION (provided by applicant): Tobacco use remains the single most preventable cause of premature deaths and cancer.1 Building on more than a decade of clinical and research experience in treating tobacco-dependence, we propose to address this problem with a new academic-small computer game business partnership that will develop a novel e-health tobacco cessation and relapse prevention product. Smoking relapse following a quit attempt remains a significant public health concern with high costs in quality-adjusted life years. A growing body of evidence suggests that continued practice, or behavioral rehearsal, can help smokers effectively manage smoking cues, and also that cues to smoke can be triggered virtually via interaction with a computer.2 Thus, we propose to create a 3D game intervention that aims to help smokers rehearse effective strategies and improve self- efficacy for managing smoking triggers. Given our preliminary work with this concept, our combined expertise, and the commercialization potential of this concept, we are pursuing a Fast Track submission. In Phase I we plan to transform our coping skills simulation developed in the virtual world Second Life to an accessible, structured gaming environment with elements essential for a full-fledged interactive game designed to promote tobacco cessation. Using a systematic feedback protocol, we will refine the game's usability, relevance and utility using patient volunteers recruited from the Memorial Sloan-Kettering Tobacco Cessation Program and behavioral science researchers with expertise in treating tobacco dependence. In Phase II we will incorporate alpha testing data and complete development of the coping skills game, including the 3D environment and game avatars, game design and scripts for coping skills, feedback and rewards for patients, and data collection capabilities. Then, using a randomized trial design conducted at Memorial Sloan-Kettering Cancer Center, we will test the game's potential to increase coping self-efficacy and decrease relapse to smoking among hospitalized cancer patients. Although rates of cessation among patients newly diagnosed with tobacco-related cancers are typically high, many continue to smoke or resume smoking shortly after discharge from the smoke- free, hospital environment.3-5 Despite often reporting high motivation to quit and serious consequences of continued smoking, cancer patients are at high risk for smoking relapse following hospitalization and an ideal population with which to test the potential of our game. We will randomize 190 patients using a two-group design (Usual Care + Smoking Cues Coping Skills Game vs. Usual Care Only) and gather self-efficacy and tobacco use data at 1, 3, and 6 months following hospitalization. The proposed study has the potential for high impact if our novel coping skills game shows efficacy for enhancing the treatment of tobacco dependence. This concept is highly marketable to a broad target audience of hospitalized smokers and may offer numerous benefits as an adjunct to current cessation interventions.