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，它们的绝对功效被削弱了，因为许多参与者通常花相对较少的时间访问计划内容。一种可能的解决方案是增加治疗组件，将其传送到参与者的手机上。超过90%的美国人使用手机，而且大多数人一整天都把手机放在身边。因此，这些移动设备可以在最需要的时候提供及时的帮助，它们主动地向用户提供内容，并提高其利用率和知名度。目的：我们提出了一项对照试验，评估与辅助移动干预结合基于网络的最佳实践戒烟干预相关的烟草戒断。我们假设这种Web Mobile方法将比Web Only条件产生更大的效果。方法：我们提出了一项包含2260名成人研究参与者的两组随机对照试验，随机分为移动网络组和纯网络组。因为核心问题是联合网络移动方法是否能提高疗效，所以这两种情况都使用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所测试的增强干预措施的许多特征。移动方式包括自动短信（SMS）和自动电话呼叫（IVR或交互式语音应答）。措施：我们的主要结果是持续的烟草戒断，从3个月的评估到6个月的评估期间定义为不使用烟草。在3个月和6个月的随访评估中，我们测量了7天和30天的烟草戒断率。我们还比较了每个实验条件下的干预成本和增量成本效益（每个参与者的成本和每个退出的成本）。辅助分析将检查潜在的预测因子、调节因子和假定的调节因子（即自我效能、程序使用、药理学辅助剂的使用）。益处：据我们所知，本应用程序描述了第一个评估在基于网络的戒烟干预中添加移动组件的增量效果的随机对照试验。评估在网络干预中增加移动组件的价值将对公共卫生产生重大影响，因为这种干预能够经济有效地接触到许多想要戒烟的吸烟者。该研究还将通过寻求确定有益的辅助机制来推进网络移动干预的新兴科学。

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.