Preventing postpartum smoking relapse: a twitter-enabled supportive intervention

项目总结/摘要 据估计，40%的吸烟妇女在怀孕期间戒烟，然而，高达80%的这些妇女， 尽管对她们自己和孩子的健康有风险，但她们在产后期间仍然会复发。复发 产后期的预防为利用积极的行为变化提供了一个独特的机会。 然而，设计有效的预防产后复发的吸烟干预措施是具有挑战性的，因为在很大程度上， 这部分人口的竞争性需求和压力，特别是低收入妇女。新的， 需要创新的干预提供模式，以提供高水平的社会支持， 行为改变，同时解决与幼儿相关的新需求。推特， 最受欢迎的微博社交媒体平台之一，促进即时通信模式 通过推文（短信），似乎特别有希望提供戒烟干预， 服务不足的人群。在认知-社会健康信息处理（C-SHIP）框架的指导下， 以及健康传播的最佳做法，拟议的研究将开发和测试的证据- 基于认知行为的Twitter支持的系统生成和参与者驱动的干预 （Tweet 2commit）旨在减少低收入少数民族妇女产后吸烟复发， 在怀孕前或怀孕期间立即戒烟。Tweet 2commit将通过一个 系统的形成性评价过程，包括文献和循证内容审查，随后 通过文本起草、文本健康素养评估、目标焦点小组审查和 通过可用性测试进行预测试。Tweet 2commit的首要目标是提供基于证据的 信息和认知行为应对策略，以及利用同伴介导的潜力 社会互动，支持戒烟。干预措施将包括：1）系统生成的 针对基于C-SHIP的复发因素的推文和2）用户生成的推文：将要求参与者 在评论系统生成的推文时，或在遇到需要应对失误时， 所以他们的同伴可以做出相应的反应。我们还将使用最佳实践策略的组合， 参与在线参与和同行支持交流。将进行一项试验性RCT，以探索疗效 的Tweet 2commit干预降低产后复发率，相比产后护理控制。一 混合方法的方法，包括客观的Twitter使用数据的分析将进行测量 参与者的参与度和满意度以及感知障碍。这项研究将是第一个 一项利用Twitter传播循证吸烟的潜力的随机对照研究 戒烟战略和利用推文的参与性质提供现场互动移动的支持 产后妇女中缺乏服务的群体。该方法是创新的，以证据为基础的， 可运输用于大规模传播，并且可以容易地应用于其他药物滥用情况。

Project Summary/Abstract An estimated 40% of women who smoke quit during their pregnancy, however, up to 80% of these women relapse in the postpartum period, despite the health risks for themselves and their children. Relapse prevention in the postpartum period offers a unique opportunity to capitalize on a positive behavioral change. Yet, the design of effective smoking interventions for postpartum relapse prevention is challenging, due in large part to the competing needs and stressors in this population, especially among low income women. New, innovative intervention delivery models are needed to provide high levels of social support for ongoing behavioral change, while simultaneously addressing the new demands associated with young babies. Twitter, one of the most popular microblogging social media platforms that facilitate an instant mode of communication via tweets (short texts), seems especially promising for delivering smoking cessation interventions among underserved populations. Guided by the Cognitive-Social Health Information Processing (C-SHIP) framework, as well as by health communication best practices, the proposed study will develop and test an evidence- based, cognitive-behavioral twitter-enabled system-generated and participant-driven intervention (Tweet2commit) designed to reduce postpartum smoking relapse among low-income minority women who have quit immediately before or during their pregnancies. The Tweet2commit will be developed through a systematic formative evaluation process that includes literature and evidence-based content review, followed by an iterative cycling of text drafting, health literacy evaluation of texts, review by targeted focus group and pre-test through usability testing. The overarching goal of Tweet2commit is to provide evidence-based information and cognitive-behavioral coping strategies, as well as to harness the potential of peer-mediated social interaction, for supporting smoking abstinence. The intervention will consist of: 1) system-generated tweets targeting C-SHIP-based relapse factors and 2) user-generated tweets: participants will be asked to tweet when commenting on the system-generated tweets or when experiencing needs for coping with lapse or relapse so their peer can respond accordingly. We will also use a combination of best practice strategies to engage online participation and peer-support exchange. A pilot RCT will be conducted to explore the efficacy of the Tweet2commit intervention on reducing postpartum relapse rates, compared to a Usual Care control. A mixed-methods approach including the analysis of objective Twitter usage data will be conducted to measure participant’s engagement and satisfaction as well as perceived barriers. The proposed research will be the first randomized controlled study that leverages the potential of Twitter for disseminating evidence-based smoking cessation strategies and harnessing the participatory nature of tweeting for live interactive mobile support groups among underserved postpartum women. The approach is innovative, evidence-based, highly transportable for wide scale dissemination, and can readily be applied to other substance abuse contexts.