Addressing Psychological Risk Factors Underlying Smoking Persistence in COPD Patients

解决慢性阻塞性肺病患者持续吸烟的心理危险因素

• 批准号: 9370437
• 负责人: Amanda R Mathew
• 金额: $ 14.25万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-08-01 至 2022-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9370437
• 关键词: Abstinence; Achievement; Address; Affect; Anhedonia; Anxiety; Area; Behavior Therapy; Behavioral; Behavioral Medicine; Buffers; Chronic Obstructive Airway Disease; Clinical; Cognitive; Combined Modality Therapy; Comorbidity; Data; Development; Diagnosis; Disease Progression; Distress; Doctor of Philosophy; Dyspnea; Early treatment; Elements; Emotional disorder; Exercise Tolerance; Feedback; Fostering; Future; Goals; Health; Hospitalization; Hour; Human; Individual; Intervention; Interview; Knowledge; Laboratories; Lead; Measures; Medical; Mental Depression; Mentored Patient-Oriented Research Career Development Award; Mentorship; Methodology; Methods; Morbidity - disease rate; Nicotine; Nicotine Dependence; Nurses; Outcome; Outcome Measure; Participant; Patient Self-Report; Patients; Persons; Pharmacotherapy; Phase; Population; Preventive Medicine; Protocols documentation; Provider; Psychological Factors; Quality of life; Randomized; Randomized Controlled Trials; Recruitment Activity; Regulation; Reporting; Research; Research Assistant; Research Priority; Risk Factors; Safety; Sampling; Scientist; Series; Smoke; Smoker; Smoking; Smoking Cessation Intervention; Smoking Status; Stress; Structure; Symptoms; Testing; Tobacco; Training; Treatment Efficacy; Treatment Factor; Universities; Withholding Treatment; Work; anxiety sensitivity; anxiety symptoms; base; behavioral health; career; career development; cigarette smoking; clinical care; clinically significant; depressive symptoms; design; effective therapy; experimental study; health disparity; high risk; improved; indexing; individualized medicine; medical schools; mindfulness; mortality; multi-component intervention; multidisciplinary; novel; pilot trial; pleasure; primary outcome; professor; psychologic; pulmonary rehabilitation; respiratory; response; secondary outcome; self help; skills; smoking cessation; targeted treatment; therapy design; therapy development; treatment adherence; treatment as usual; trial design

PROJECT SUMMARY/ABSTRACT Chronic Obstructive Pulmonary Disease (COPD) is caused primarily by smoking and smoking cessation is the first-line treatment for slowing disease progression. Despite this, nearly 50% of COPD patients continue to smoke following diagnosis. Smokers with COPD report high rates of co-occurring conditions – nicotine dependence, depression, and anxiety – which serve as barriers to quitting. The proposed research will develop and pilot test a behavioral intervention designed to target the common psychological factors underlying these co-occurring conditions and foster smoking cessation among COPD patients. Primary aims of the proposed research are to: 1) Refine behavioral treatment components through qualitative interviews with patients and providers, 2) Develop a tailored behavioral treatment to address psychological risk factors among COPD patients using single case design experiments, and 3) Conduct a pilot randomized controlled trial (RCT) to examine the effects of the multi-component intervention on smoking outcome, as compared to minimally-enhanced usual care. The proposed project will be the first to adapt a behavioral treatment to specifically target psychological risk factors among COPD patients who smoke. By addressing core psychological risk factors, the behavioral treatment may help buffer against stress associated with disease progression and increase COPD patients' exercise tolerance, engagement in pulmonary rehabilitation, and quality of life. Thus, this intervention has potential to obviate a large number of health burdens among COPD patients, and ultimately to reduce morbidity and mortality associated with COPD. Amanda Mathew, PhD, a Research Assistant Professor at Northwestern University Feinberg School of Medicine, is seeking five years of support through the K23 Mentored Patient-Oriented Research Career Development Award for training and research related to development and testing of smoking cessation interventions targeted to psychological risk factors among COPD patients. Dr. Mathew's overarching career goals are to elucidate the mechanisms by which psychological factors impact cigarette smoking, develop novel interventions for smokers with medical and psychiatric comorbidities, and reduce tobacco-related health disparities. Through the proposed training plan, Dr. Mathew will expand her knowledge and skills related to intervention development; behavioral RCT design, conduct, and analysis; and smoking cessation and treatment needs specific to individuals with COPD. Dr. Mathew's multidisciplinary mentorship team has demonstrated expertise in these content areas, and is committed to Dr. Mathew's career development. Dr. Mathew's proposed work is also well-aligned with behavioral medicine research priorities within the Department of Preventive Medicine at Northwestern University Feinberg School of Medicine.

项目概要/摘要 慢性阻塞性肺疾病（COPD）主要由吸烟和吸烟引起 戒烟是减缓疾病进展的一线治疗方法。尽管如此，近 50% 的 COPD 患者 诊断后继续吸烟。患有慢性阻塞性肺病 (COPD) 的吸烟者报告并发病症的比例很高 – 尼古丁依赖、抑郁和焦虑——这些都是戒烟的障碍。拟议的研究将 开发并试点测试旨在针对常见心理因素的行为干预措施 潜在的这些共同发生的条件并促进慢性阻塞性肺病患者戒烟。 拟议研究的主要目的是：1）通过以下方式完善行为治疗组成部分： 与患者和提供者进行定性访谈，2) 制定量身定制的行为治疗方案来解决 使用单病例设计实验研究 COPD 患者的心理危险因素，以及 3) 进行试点 随机对照试验 (RCT) 检查多成分干预对吸烟的影响 与最低限度强化的常规护理相比。拟议的项目将是第一个适应 行为治疗专门针对吸烟的慢性阻塞性肺病患者的心理危险因素。经过 针对核心心理风险因素，行为治疗可能有助于缓解相关压力 随着疾病进展并提高慢性阻塞性肺病患者的运动耐量、参与肺功能 康复和生活质量。因此，这种干预措施有可能消除大量健康问题 慢性阻塞性肺病患者的负担，并最终降低与慢性阻塞性肺病相关的发病率和死亡率。 阿曼达·马修（Amanda Mathew）博士，西北大学范伯格学院研究助理教授 医学，正在通过 K23 指导的以患者为导向的研究职业寻求五年的支持 与戒烟开发和测试相关的培训和研究发展奖 针对 COPD 患者心理危险因素的干预措施。马修博士的总体职业生涯 目标是阐明心理因素影响吸烟的机制，开发新的 对患有医学和精神合并症的吸烟者进行干预，并减少与烟草相关的健康 差异。通过拟议的培训计划，马修博士将扩展她的相关知识和技能 干预发展；行为随机对照试验设计、实施和分析；以及戒烟和 慢性阻塞性肺病患者特有的治疗需求。 Mathew 博士的多学科导师团队 在这些内容领域展示了专业知识，并致力于马修博士的职业发展。博士。 马修提出的工作也与行为医学研究重点相一致 西北大学范伯格医学院预防医学系。