Effects of Message Framing on Cessation among Couples where both Partners Smoke

消息框架对双方吸烟的夫妇戒烟的影响

• 批准号: 8240680
• 负责人: ISAAC M LIPKUS
• 金额: $ 24.07万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-03-01 至 2014-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8240680
• 关键词: Abstinence; Affect; Appearance; Attention; Behavioral; Cells; Commit; Couples; Data; Disadvantaged; Evaluation; Exposure to; Failure; Family; Future; Guidelines; Health; Home environment; Individual; Influentials; Intervention; Interview; Investigation; Joints; Life; Literature; Measures; Mediator of activation protein; Motivation; Outcome; Participant; Patient Self-Report; Persons; Prevalence; Process; Public Health; Questionnaires; Randomized; Reaction; Relapse; Research; Research Personnel; Risk; Self Efficacy; Smoke; Smoker; Smoking; Smoking Behavior; Smoking Cessation Intervention; Social support; Surveys; System; Text; Time; Transcript; Work; Writing; base; behavior change; clinical practice; coping; cost; design; effective intervention; follow-up; high risk; insight; member; novel; post intervention; randomized trial; risk perception; self help; sex; smoking cessation; theories; therapy design

DESCRIPTION (provided by applicant): Couples in which both members smoke represent key targets for smoking cessation interventions. Quit rates are lower and relapse rates are higher among these individuals, and each person's health risks are amplified due to exposure to their partner's smoking. As a strategy to promote quit, and despite these facts, message framing interventions have not highlighted how smoking outcomes related to health, appearance and finances might affect both partners in a couple jointly. For couples in which both partners smoke, intervention messages can highlight how positive outcomes of quitting (i.e., positive frame) or costs of not quitting (i.e., negative frame) affect the individual smoker or the couple. This study extends prior framing research by examining how gain- versus loss-framed messages focused on individual- versus couple-level outcomes influence (a) message acceptance, operationalized by evaluations of message accuracy, credibility and outcome relevance; (b) likely mediators of successful cessation at both individual and relationship levels, including intentions, risk perceptions, self- and dyadic efficacy, and communal coping operationalized both by self-report and first person plural pronoun use (we-talk) in a couple conversation about quitting; and (c) smoking behavior change over 6 months, verified biochemically. Participants will be 120 couples (married or living as married, same and opposite sex) in which both members smoke and neither plans to quit during the next 30 days. We will randomize couples to 1 of 4 cells in a 2 x 2 factorial design that crosses gain vs. loss frame with self vs. couple outcomes focus. The specific intervention manipulations will be implemented and reinforced via written narratives, summaries of key framing points, and booster messages given 1 week after the initial intervention session. In addition to a baseline assessment before randomization, couples will complete an immediate post-intervention survey assessing message acceptance plus hypothesized individual and relational mediators; participate in a joint post-intervention interview about smoking (with transcripts later yielding "we-talk" via automatic text analysis); and provide follow-up data 1 and 6 months later to assess outcomes such as intentions to quit, amount smoked, and cessation. We hypothesize that (a) framed messages focused on couple- rather than individual-level outcomes will be more effective in motivating quitting; (b) gain-framed messages will be more persuasive than loss-framed messages, especially when the message outcome focus is the couple; (c) couple-focused messages will be most effective in prompting hypothesized relational change mechanisms such as dyadic efficacy and communal coping; and (d) all these associations will be stronger in couples with high relationship quality. If results provide preliminary support for these novel and uninvestigated hypotheses, effect size estimates will be used to propose a larger randomized trial. This research should add important strategic insights to new applications of message framing in clinical practice and public health when the high-risk target group is couples in which both partners smoke. PUBLIC HEALTH RELEVANCE: This study is the first to explore among couples in which both members smoke (dual smoking couple), how message framing, that is, presenting either the benefits of quitting versus the disadvantages of continuing to smoke as they affect the individual or the couple, influence processes of quitting. Findings should add important strategic insights to new applications of message framing in clinical practice and public health targeting dual smoking couples.

描述（由申请人提供）：双方都吸烟的夫妇是戒烟干预的关键目标。这些人的戒烟率较低，复吸率较高，而且每个人的健康风险都会因伴侣吸烟而放大。作为促进戒烟的策略，尽管有这些事实，信息框架干预措施并没有强调与健康、外表和财务相关的吸烟结果可能如何共同影响夫妻双方。对于双方都吸烟的夫妇，干预信息可以强调戒烟的积极结果（即积极框架）或不戒烟的成本（即消极框架）如何影响吸烟者个人或夫妇。本研究扩展了先前的框架研究，研究了关注个人与夫妻层面结果的增益与损失框架消息如何影响（a）消息接受度，通过评估消息准确性、可信度和结果相关性来实施； (b) 在个人和关系层面上成功戒烟的可能中介因素， 包括意图、风险认知、自我和二元功效，以及通过自我报告和在关于戒烟的夫妻对话中使用第一人称复数代词（我们谈话）来实施的集体应对； (c) 6 个月内吸烟行为的变化，经生化验证。参与者将是 120 对夫妇（已婚或已婚同居，同性和异性），其中双方都吸烟，且双方均未计划在未来 30 天内戒烟。我们将在 2 x 2 因子设计中将耦合随机化到 4 个单元格中的 1 个，该设计将增益与损失框架与 自我与夫妻结果的焦点。具体的干预操作将通过书面叙述、关键框架点总结以及在初次干预会议后 1 周给出的加强信息来实施和强化。除了随机化前的基线评估外，夫妇还将立即完成一项干预后调查，评估信息接受程度以及假设的个人和关系调解因素；参与有关吸烟的干预后联合访谈（随后通过自动文本分析生成“我们谈话”的笔录）；并在 1 个月和 6 个月后提供后续数据，以评估戒烟意向、吸烟量和戒烟等结果。我们假设 (a) 关注夫妻而非个人层面结果的框架信息将更有效地激励戒烟； (b) 以获益为框架的信息比以损失为框架的信息更有说服力，特别是当信息结果的焦点是夫妻时； (c) 以夫妻为中心的信息将最有效地促进假设的关系改变机制，例如二元效能和共同应对； (d) 在关系质量高的夫妻中，所有这些关联都会更强。如果结果为这些新颖且未经调查的假设提供了初步支持，则效应大小估计将用于提出更大规模的随机试验。当高风险目标群体是双方都吸烟的夫妇时，这项研究应该为信息框架在临床实践和公共卫生中的新应用增添重要的战略见解。 公共卫生相关性：本研究首次探讨了双方都吸烟的夫妇（双吸烟夫妇）中的信息框架（即介绍戒烟的好处和继续吸烟的坏处，因为它们影响个人或夫妇）如何影响戒烟过程。研究结果将为消息框架在临床实践和针对双吸烟夫妇的公共卫生中的新应用提供重要的战略见解。