Web and Mobile Smoking Cessation Interventions

描述(由申请人提供)：基于网络的健康行为改变干预措施--包括戒烟计划--提供了巨大的希望，但在许多情况下，其绝对有效性被削弱，因为许多参与者通常花费相对较少的时间访问计划内容。一种可能的解决方案包括添加治疗组件，这些组件被送到参与者的手机上。超过90%的美国人使用手机，大多数人全天都把手机放在很近的地方。因此，这些移动设备可以在最需要的时候及时提供帮助，而且它们主动接触用户，以提供内容并提高其利用率和重要性。目的：我们提出了一项评估与辅助移动干预和最佳实践网络戒烟干预相结合的烟草戒烟的对照试验。我们假设，这种Web Mobile方法将比纯Web条件下产生更大的效率。方法：我们提出了一项双臂随机对照试验，将2260名成人研究参与者随机分为网络移动组和纯网络组。由于核心问题是联合网络移动方法是否提高了疗效，这两种情况都使用了非常相似的最佳实践核心网站，该网站体现了我们之前基于网络的戒烟试验中测试的增强干预措施中的许多功能。移动设备包括自动文本消息(SMS)和自动电话呼叫(IVR或交互式语音响应)。措施：我们的主要结果是持续戒烟，在操作上被定义为从3个月评估到6个月评估期间不使用烟草。在3个月和6个月的随访评估中，我们测量了7天和30天的烟草戒断时点流行率。我们还比较了每种实验条件的干预成本和增量成本效果(每次参与者成本和每次退出成本)。辅助分析将检查潜在的预测因素、调节因素和假定的中介因素(即自我效能、程序使用、药理辅助使用)。好处：据我们所知，该应用程序描述了第一个评估将移动组件添加到基于网络的戒烟干预中的增量有效性的随机对照试验。评估将移动组件添加到网络干预中的价值将会对公共健康产生重大影响，因为这种干预能够经济高效地接触到许多想要戒烟的吸烟者。这项研究还将通过寻找有益的辅助机制来推动网络移动干预这一新兴科学的发展。

DESCRIPTION (provided by applicant): Web-based health behavior change interventions - including smoking cessation programs - offer great promise but in many cases their absolute efficacy is diminished because many participants often spend relatively little time accessing program content. One potential solution involves adding treatment components that are delivered to participants' mobile phones. More than 90% of Americans use mobile phones and most keep their phones in close proximity throughout the day. As a result, these mobile devices can provide just in time assistance when it is most needed and they are proactive in that they reach out to users to deliver content and to increase its utilization and salience. Objectives: We propose a controlled test assessing tobacco abstinence associated with an adjunctive Mobile intervention combined with a best-practices Web-based smoking cessation intervention. We hypothesize that this Web Mobile approach will yield greater efficacy than a Web Only condition. Methods: We propose a 2-arm RCT with 2,260 adult study participants randomized to a Web Mobile or a Web Only condition. Because the central question is whether the combined Web Mobile approach improves efficacy, both conditions use a very similar best-practices core website that embodies many of the features found in the enhanced interventions tested in our prior Web-based tobacco cessation trials. The mobile modalities include automated text messages (SMS) and automated phone calls (IVR or Interactive Voice Response). Measures: Our primary outcome is sustained tobacco abstinence operationally defined as no tobacco use during the interval defined from the 3-month assessment to the 6-month assessment. At both the 3- and 6- month follow-up assessments we measure 7- and 30-day point prevalence tobacco abstinence. We also compare the intervention cost and incremental cost-effectiveness (cost per-participant and cost per-quit) of each experimental condition. Ancillary analyses will examine potential predictors, moderators, and putative mediators (i.e., self-efficacy, program use, use of pharmacological adjuncts). Benefits: To the best of our knowledge, this application describes the first RCT that assesses the incremental efficacy of adding Mobile components to a Web-based smoking cessation intervention. Evaluating the value of adding Mobile components to a Web intervention will have substantial public health impact because such interventions are able to cost-effectively reach many smokers who want to quit. The research will also advance the emerging science of Web Mobile interventions by seeking to identify beneficial adjunctive mechanisms.