Decision support for smoking cessation in young adults with severe mental illness

患有严重精神疾病的年轻人戒烟的决策支持

• 批准号: 8538895
• 负责人: Mary Frances Brunette
• 金额: $ 20.39万
• 依托单位: DARTMOUTH COLLEGE
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-01 至 2015-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8538895
• 关键词: Address; Adult; Age; American; Attitude; Behavior; Behavior Control; Belief; Characteristics; Cognitive deficits; Computers; Decision Support Systems; Development; Diabetes Mellitus; Disease; Economics; Electronics; Exercise; Goals; Health; Health behavior; Heart Diseases; Intention; Intervention; Life Expectancy; Lung diseases; Malignant Neoplasms; Mental Health; Mental disorders; Methods; Mood Disorders; Morbidity - disease rate; Motivation; Online Systems; Outcome; Pamphlets; Patients; Perception; Planning Theory; Population; Psychotic Disorders; Quality of life; Randomized Controlled Trials; Research; Research Personnel; Schizophrenia; Smoke; Smoker; Smoking; Staging; Stroke; Symptoms; Systems Development; Testing; Text; Time; Tobacco; Withholding Treatment; Work; base; behavior influence; burden of illness; computer program; computerized; cost; cost effective; design; effective therapy; efficacy testing; experience; improved; interest; middle age; mortality; motivational intervention; non-smoker; prevent; severe mental illness; smoking cessation; social norm; theories; usability; young adult

DESCRIPTION (provided by applicant): Up to 77% of young Americans with severe mental illnesses (SMI: schizophrenia and severe mood disorders) smoke, a rate that is up to five times higher than the rate of daily smoking in other young adults. This group goes on to experience very high rates of morbidity and mortality due to smoking-related diseases. Motivational interventions can engage SMI smokers into cessation but have not been tested in young, transitional age adults with SMI, who require interventions that address their unique characteristics and needs. The investigators have developed a basic, easy-to-use, motivational electronic decision support system (EDSS) tailored for smokers with SMI. Although pilot testing in middle-aged SMI adults provided promising results, recent pilot work among young SMI smokers indicated that the EDSS, although motivating, required further development. To address the need for low cost, effective motivational interventions for this group, we propose here to further develop and then test our theory-based EDSS -- the product will be an easy-to-use and implement web-based intervention to motivate young SMI smokers to quit with effective cessation treatments. The EDSS development proposed here will be based on the Theory of Planned Behavior, which states that population-specific beliefs, attitudes, social norms, and perceived behavioral control regarding a health behavior can be changed to increase intention and behavior enactment. In Year 1, we will identify the beliefs of young SMI smokers that impede use of cessation treatments. The EDSS will then be revised to change these beliefs (and related attitudes, social norms and perceived behavioral control) with new design, text, interactive exercises, and video patient stories. The revised EDSS will be field-tested for usability among young SMI smokers and improved as needed. In Year 2, we will conduct an RCT among 60 young smokers with SMI psychotic disorders comparing the EDSS to a computerized version of a standard smoking cessation pamphlet. Analyses will assess whether use of the EDSS results in greater clinician-confirmed initiation of cessation treatment, as well as changes in beliefs about treatment. This study will set the stage for an R01 application to conduct a full RCT to test the efficacy of the revised EDSS to motivate young SMI smokers to use cessation treatment. The ultimate goals of this intervention are to extend life expectancy, reduce illness burdens and increase quality of life for Americans with SMI.

描述（由申请人提供）：高达77%的严重精神疾病（SMI：精神分裂症和严重情绪障碍）的年轻美国人吸烟，这一比率比其他年轻人每天吸烟的比率高出五倍。这一群体因吸烟引起的疾病的发病率和死亡率很高。动机干预可以使SMI吸烟者戒烟，但尚未在年轻的过渡年龄的SMI成年人中进行测试，他们需要针对其独特的特征和需求的干预措施。研究人员开发了一个基本的，易于使用的，激励性的电子决策支持系统（EDSS），为患有SMI的吸烟者量身定制。尽管在中年重度吸烟成年人中进行的试点测试取得了令人鼓舞的结果，但最近在年轻重度吸烟者中进行的试点工作表明，EDSS尽管具有激励作用，但仍需要进一步发展。为了满足这一群体对低成本，有效的动机干预的需求，我们建议在这里进一步开发，然后测试我们的理论为基础的EDSS -该产品将是一个易于使用和实施基于网络的干预，以激励年轻的SMI吸烟者戒烟有效的戒烟治疗。 这里提出的EDSS开发将基于计划行为理论，该理论指出，可以改变人群特定的信念，态度，社会规范和感知的行为控制，以增加意图和行为制定。在第一年，我们将确定年轻SMI吸烟者阻碍使用戒烟治疗的信念。然后，EDSS将被修改，以改变这些信念（和相关的态度，社会规范和感知的行为控制）与新的设计，文本，互动练习，和视频病人的故事。修订后的EDSS将进行现场测试，以确定是否适用于年轻的SMI吸烟者，并根据需要进行改进。在第2年，我们将在60名患有精神障碍的年轻吸烟者中进行随机对照试验，将EDSS与标准戒烟小册子的计算机版本进行比较。分析将评估EDSS的使用是否会导致更多临床医生确认的停止治疗的开始，以及对治疗的信念的变化。这项研究将为R 01申请奠定基础，以进行一项全面的RCT，以测试修订后的EDSS在激励年轻的重度精神疾病吸烟者使用戒烟治疗方面的有效性。这种干预的最终目标是延长预期寿命，减少疾病负担，提高美国SMI患者的生活质量。