Testing Relapse Recovery Intervention Components

测试复发恢复干预成分

• 批准号: 8655747
• 负责人: Timothy B Baker
• 金额: $ 9万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-01 至 2019-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8655747
• 关键词: Abstinence; Address; Adverse effects; Belief; Cancer Etiology; Cause of Death; Cessation of life; Chronic; Chronic Care; Clinical Trials Design; Cognitive; Counseling; Dose; Enrollment; Goals; Healthcare; Hour; Intervention; Malignant Neoplasms; Mediator of activation protein; Methodology; Modeling; Nicotine Dependence; Outcome; Participant; Pharmaceutical Preparations; Phase; Preparation; Public Health; Randomized; Randomized Controlled Trials; Recovery; Recurrent disease; Recycling; Relapse; Research; Research Project Grants; Self Efficacy; Smoker; Smoking; Testing; Tobacco Dependence; Training Support; Translations; Treatment Factor; Withdrawal; Withholding Treatment; base; cancer risk; clinical practice; combat; comparative effectiveness; craving; design; effective intervention; effective therapy; effectiveness research; improved; medication compliance; mortality; nicotine gum; novel; programs; randomized trial; response; skills training; smoking intervention; smoking prevalence; theories

Smoking is the leading preventable cause of cancer mortality in the US, making improved smoking treatment a vital public health goal. However, most smokers trying to quit ultimately relapse, and little is known about how to treat them. This project is designed to identify highly effective intervention components for recently relapsed smokers that can be included in a chronic care treatment for smoking that comprises effective intervention components for every phase of smoking treatment and that is feasible for use in healthcare settings. Participants from Project 3 of this POI application (the Cessation RCT) who relapse will transition to this Relapse Recovery project (N~776). Three intervention factors (each comparing an enhanced intervention component with a standard one) will be tested using a factorial Sequential Multiple Assignment Randomized Trial (SMART) design. All participants will be randomized to a Preparation factor comparing two strategies for preparing relapsers to requit. However, only participants choosing to make a new quit attempt will be randomized to the two Cessation factors: 1) Personalized vs. Regular Cessation Medication, and 2) Front-loaded vs. Regular Cessation Counseling. The enhanced Preparation and Cessation intervention components are designed to address the major challenges facing relapsers. The enhanced Preparation component (Smoking Reduction Counseling) is designed to counter demoralization and reduce tobacco dependence. Personalized Cessation Medication is designed to increase medication adherence and reduce withdrawal craving during a quit attempt, while Front-loaded Cessation Counseling is designed to reduce early lapsing by providing support and skills training early in the quit attempt. Analyses will determine the main and interactive effects of the two Cessation factors on smoking abstinence and determine whether these effects differ as a function of the Preparation factor. Analyses will also determine the effects of the Preparation factor on the likelihood of a meaningful quit attempt. The proposed research will be the first comparative effectiveness research to evaluate novel but promising Relapse Recovery intervention components in healthcare settings thus facilitating their rapid translation to real-world use.

在美国，吸烟是癌症死亡的首要可预防原因，这使得改善吸烟治疗成为一个重要的公共健康目标。然而，大多数试图戒烟的吸烟者最终会复发，而且对如何治疗他们知之甚少。该项目旨在为最近复发的吸烟者确定可包括在吸烟慢性护理治疗中的高效干预成分，该治疗包括吸烟治疗的每个阶段的有效干预成分，并且在医疗保健环境中使用是可行的。来自此POI应用程序项目3(戒毒RCT)的复发参与者将过渡到此复发恢复项目(N~776)。三个干预因素(每个都将增强干预成分与标准干预成分进行比较)将使用析因序贯多分配随机试验(SMART)设计进行测试。所有参与者将被随机分配到一个准备因素，比较两种准备复吸者的策略。然而，只有选择进行新的戒烟尝试的参与者才会被随机分为两个戒烟因素：1)个性化戒烟药物与常规戒烟药物，以及2)提前戒烟与常规戒烟咨询。增强的准备和戒烟干预部分旨在应对复吸者面临的主要挑战。增强的准备部分(减少吸烟咨询)旨在对抗士气低落和减少烟草依赖。个性化的戒烟药物旨在提高戒烟期间的用药依从性，减少戒烟渴望，而前端戒烟咨询旨在通过在戒烟尝试早期提供支持和技能培训来减少早期失误。分析将确定两种戒烟因素对戒烟的主要和相互作用的影响，并确定这些影响是否作为准备因素的函数而不同。分析还将确定准备因素对有意义的戒烟尝试的可能性的影响。这项拟议的研究将是第一个评估医疗保健环境中新的但有前景的复发恢复干预成分的比较有效性研究，从而促进它们快速转化为现实世界的使用。