Technology-Enhanced Quitline Services to Prevent Smoking Relapse

描述(申请人提供)：每年有1900多万美国吸烟者为了戒烟而戒烟一天以上，但只有5%的人会保持戒烟一年，大多数人在戒烟后一个月内重新吸烟。戒烟后复发是一个重要的健康问题，也是试图保持戒烟状态的个人面临的最大问题。这项研究的目的是测试IVR技术在增强广泛使用的烟草治疗服务提供模式(Free&Clear‘s Quit for Life(R)计划)以防止吸烟复发和实现戒烟方面的有效性。我们的技术将通过(1)在戒烟后日期期间对个人进行筛查以增加复发风险，以及(2)在需要时根据个人现有的风险因素提供基于证据的电话咨询，从而增强戒烟服务。使用IVR监测，将对个人进行筛查，以确定复发风险增加的特定指标，包括吸烟失误、身体戒断症状、抑郁症状、感知到的压力、戒烟自我效能降低和戒烟动机减弱。除了这些公认的复发预测因素外，有令人信服的证据表明，戒烟后的头两周，复发的风险最大。因此，我们建议比较两种模型的IVR筛查的时间和频率。在技术增强型Quitline(TEQ)ARM中，10个主动IVR呼叫将在退出后8周内以递减频率发出(前两周每周两次，然后每周两次)。在高强度技术增强型Quitline(HI-TEQ)ARM中，将在戒烟后8周内发出20个主动IVR呼叫(前2周每天，然后每周)。这项拟议的研究是一项随机对照试验，旨在比较戒烟6个月和12个月时戒烟和终生戒烟计划参与者的成本效益。将对三个治疗组进行比较，即(1)标准戒烟生活护理，(2)结合电话戒烟治疗服务(TEQ)对吸烟复发风险进行IVR监测，以及(3)结合电话戒烟治疗服务(HI-TEQ)对吸烟复发风险进行高频监测。受试者将从Free&Clear终身戒烟电话戒烟治疗计划的三个大客户(两个雇主和一个健康计划客户)中招募。如果成功，这种干预措施可以被纳入现有的戒烟方案，并提供给数百万试图戒烟的人，满足传播有效戒烟干预措施的重大公共卫生需求。

DESCRIPTION (provided by applicant): Each year, over 19 million Americans smokers stop smoking for more than one day in an attempt to quit smoking, yet as few as 5% will maintain abstinence for one year, with most returning to smoking within one month of quitting. Relapse after smoking cessation is an important health concern and is the most significant problem faced by individuals who are attempting to maintain abstinence from smoking. The purpose of this study is to test the efficacy of IVR technology for enhancing a widely used tobacco treatment service delivery model (Free & Clear's Quit for Life(R) program) to prevent smoking relapse and achieve abstinence. Our technology will enhance quitline services through (1) screening individuals during the post quit date period for increased risk of relapse and (2) providing evidence-based telephone counseling at the point of need tailored to the individual's extant risk factors. Using IVR monitoring, individuals will be screened for specific indicators of increased risk for relapse including smoking lapse, physical withdrawal symptoms, depressive symptoms, perceived stress, decreased self-efficacy for quitting, and decreased motivation to quit. In addition to these well-established predictors of relapse, there is compelling evidence to suggest that the risk of relapse is most intense during the first two weeks post-quit. Thus we propose to compare two models for timing and frequency of IVR screening. In the Technology Enhanced Quitline (TEQ) arm, 10 proactive IVR calls will be placed at decreasing frequency for 8 weeks post-quit (twice a week for the first two weeks, then weekly). In the High Intensity Technology-Enhanced Quitline (HI-TEQ) arm, 20 proactive IVR calls will be placed over the 8 weeks post-quit (daily for the first 2 weeks, then weekly). The proposed study is a randomized controlled trial to compare smoking abstinence and cost-effectiveness at 6 and 12 months among participants in the Quit for Life quitline program. Three treatment groups will be compared, namely (1) standard Quit for Life care, (2) IVR monitoring of risk for smoking relapse in combination with telephone-based tobacco cessation treatment service (TEQ), and (3) high frequency monitoring of risk for smoking relapse in combination with telephone- based tobacco cessation treatment service (HI-TEQ). Subjects will be recruited from three large clients (two employers and one health plan client) of the Free & Clear Quit for Life telephone-based tobacco cessation treatment program. If successful, this intervention could be incorporated into existing quitline protocols and delivered to millions of individuals who are trying to quit smoking, meeting a significant public health need for the dissemination of effective smoking cessation interventions.