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.

项目摘要/摘要 慢性阻塞性肺疾病（COPD）主要由吸烟和吸烟引起 停止是减缓疾病进展的一线治疗方法。尽管如此，几乎有50％的COPD患者 诊断后继续吸烟。患有COPD的吸烟者报告了同时发生条件的高率 - 尼古丁的依赖，抑郁和动画 - 是退出的障碍。拟议的研究将 开发和试点测试旨在针对常见心理因素的行为干预措施 这些同时发生的条件并促进了COPD患者的戒烟。 拟议研究的主要目的是：1）通过 与患者和提供者进行定性访谈，2）开发量身定制的行为治疗以解决 使用单个病例设计实验的COPD患者中的心理危险因素，3）进行飞行员 随机对照试验（RCT）检查多组分干预对吸烟的影响 结果，与最小增强的常规护理相比。拟议的项目将是第一个适应 在吸烟的COPD患者中，行为治疗特定针对心理危险因素。经过 解决核心心理危险因素，行为治疗可能有助于缓冲与压力相关的压力 随着疾病的进展并增加COPD患者的运动耐受性，参与肺部 康复和生活质量。这，这种干预有可能消除大量健康 COPD患者中的伯伦斯（Burnens），最终是为了降低与COPD相关的发病率和死亡率。 西北大学Feinberg School的研究助理教授Amanda Mathew博士 Medicine，通过K23指导的患者研究职业寻求五年的支持 培训和研究开发奖与戒烟的开发和测试有关 针对COPD患者的心理风险因素的干预措施。马修博士的总体职业 目标是阐明心理因素影响吸烟的机制，发展新颖 对吸烟者进行医学和精神病合并症的干预措施，并减少与烟草有关的健康 差异。通过拟议的培训计划，Mathew博士将扩大与 干预发展；行为RCT设计，进行和分析；和戒烟和 治疗需要针对COPD患者的特定治疗。 Mathew博士的多学科指导团队 在这些内容领域具有专业知识，并致力于Mathew博士的职业发展。博士 马修的拟议工作也与行为医学研究的重点相吻合 西北大学Feinberg医学院的预防医学系。